Sonographic assessment of the extra‐abdominal fetal small bowel in gastroschisis: a retrospective longitudinal study in relation to prenatal complications

Heinig, J.; Müller, V; Schmitz, Ralf; Lohse, K; Klockenbusch, Walter; Steinhard, J.

doi:10.1002/pd.1907

Cited by 34 publications

(35 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The ultrasound markers considered for our study were: intrauterine growth restriction (IUGR) defined as estimated fetal weight <10th percentile [18], extra-abdominal bowel dilatation (EABD) of more than 13 mm at the second and 25 mm at the third trimester [19,20,21], stomach dilatation (antero-posterior diameter measurement >2 SD [22]), stomach herniation, perturbed mesenteric circulation as diagnosed by abnormal mesenteric artery color and pulse Doppler, absence of extra-abdominal intestinal lumen, and echogenic dilated bowel loops (EDBL) defined as visible bowel lumen measuring more than 2 mm in diameter with an echogenic wall [23]. Intra-abdominal bowel diameter was measured and expressed as the ratio of observed over expected measurement for gestational age, according to reference data established in normal fetuses [21].…”

Section: Methodsmentioning

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

View full text Add to dashboard Cite

Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

show abstract

Section: Methodsmentioning

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

View full text Add to dashboard Cite

show abstract

“…While ultrasound for EFW was performed weekly by the majority of providers (79%; 104/131), at least two other studies disagreed on its ability to accurately predict adverse outcomes [27, 28]. There is also debate in the literature regarding the value of measuring bowel wall diameter and its relationship to outcomes, which may further explain the wide range of practices seen in our survey [6, 13, 15, 16, 29, 30]. …”

Section: Discussionmentioning

confidence: 74%

National Practice Patterns for Prenatal Monitoring in Gastroschisis: Gastroschisis Outcomes of Delivery (GOOD) Provider Survey

et al. 2018

View full text Add to dashboard Cite

Background: Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. Materials and Methods: An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan. Results: Responses were obtained from 29/29 (100%) NAFTNet centers, comprising 143/371 (39%) providers. The majority had a regimen for antenatal surveillance in patients with stable gastroschisis (94%; 134/141). Antenatal testing began at 32 weeks for 68% (89/131) of MFM specialists. The nonstress test (55%; 72/129), biophysical profile (50%; 63/126), and amniotic fluid index (64%; 84/131) were used weekly. Estimated fetal weight (EFW) was performed monthly by 79% (103/131) of providers. At 28 weeks, abnormal EFW (77%; 97/126) and Doppler ultrasound (78%; 99/127) most frequently altered management. In stable gastroschisis, 43% (60/140) of providers delivered at 37 weeks, and 29% (40/ 140) at 39 weeks. Discussion: Gastroschisis management differs among NAFTNet centers, although the majority initiate surveillance at 32 weeks. Timing of delivery still requires consensus. Prospective studies are necessary to further optimize practice guidelines and patient care.

show abstract

“…It appears, however, that antenatal screening cannot reliably predict morbidity, and the fact that no consensus emerges from the different studies is due mainly to the small sample size, but also to the difficulty in correlating imaging findings with clinical outcome. Some studies found a significant association between intra-abdominal bowel dilation and bowel atresia [5,17,18] . Japaraj et al [6] found that the occurrence of polyhydramnios was significantly associated with a higher rate of severe bowel com plications such as atresia, perforation and necrosis.…”

Section: Resultsmentioning

confidence: 99%

Predictive factors at birth of the severity of gastroschisis

Roessingh¹

2015

WJGP

View full text Add to dashboard Cite

Sonographic assessment of the extra‐abdominal fetal small bowel in gastroschisis: a retrospective longitudinal study in relation to prenatal complications

Abstract: Dilatation of the extra-abdominal fetal small bowel in the third trimester may allow identifying fetuses with increased risk of fetal distress requiring closer monitoring of fetal well-being or delivery in a short interval to prevent impending fetal death.

Cited by 34 publications

References 25 publications

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

National Practice Patterns for Prenatal Monitoring in Gastroschisis: Gastroschisis Outcomes of Delivery (GOOD) Provider Survey

Predictive factors at birth of the severity of gastroschisis

Contact Info

Product

Resources

About