Ultrasonographic assessment of intestinal damage in with gastroschisis: Is it of clinical value?

Lenke, Roger R.; Persutte, Wayne H.; Nemes, J

doi:10.1016/0002-9378(90)91111-o

Cited by 47 publications

(31 citation statements)

References 8 publications

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“…The initial report by Bond et al [10] identified the presence of bowel wall dilation and mural thickening as highly correlated with severe intestinal damage and poor clinical outcomes. While some studies have found positive correlation between the presence of these characteristics and neonatal morbidity and mortality [7][8][9][10], there still remains significant skepticism about their prognostic abilities [11][12][13][14]. In the current study, we investigated the predictive value of specific threshold dilation values that were considered to be clinically significant by other authors and also investigated the predictive value of bowel wall dilation at specific times during gestation.…”

Section: Discussionmentioning

confidence: 95%

“…While some studies have found positive correlation between the presence of these characteristics and neonatal morbidity and mortality [7][8][9][10], there still remains significant skepticism about their prognostic abilities [6,[11][12][13][14]. Furthermore, since different definitions of dilated bowel have been used in competing studies (17 vs. 10 mm), it is often difficult to compare these studies [15].…”

Section: Introductionmentioning

confidence: 99%

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Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome?

et al. 2009

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome?

et al. 2009

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“…The predictive value for adverse perinatal outcome of different thresholds of bowel dilatation at the last prenatal ultrasound has been previously studied [16,26,27,28,29,30,31,32,33,34,35]. Controversially, Page et al [36] in a recent systematic review concluded that IABD seen on an antenatal ultrasound scan is not a finding associated with an increased risk of adverse perinatal outcome.…”

Section: Discussionmentioning

confidence: 99%

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

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

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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.

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“…Recently two reports have questioned the predictive abilities of these sonographic findings. 5,6 We undertook this study to determine (1) whether there is a relationship between the sonographic appearance of the fetal bowel in gastroschisis and postnatal outcome; (2) if a relationship exists, whether an accurate prediction of bowel status is possible on the basis of sonographic findings; (3) whether the prenatal sonographic criteria are reproducible between observers; and (4) whether the objective sonographic criteria correlate better with bowel outcome than a subjective impression of the bowel appearance by an experienced sonologist.…”

mentioning

confidence: 99%

“…25 However, the literature now contains reports of fetuses with significantly dilated bowel on prenatal sonography who have had excellent postnatal outcome,5·6 as well as a case in which the fetal bowel appeared entirely normal on sonography but the infant died of bowel complications. 6 Recently, Langer and associates 26 reported their experience with objective prenatal sonographic criteria for predicting outcome in 24 fetuses with gastroschisis. They reported a significantly longer time to full oral feeding and increased need for bowel resection in infants with MBD of 18 mm or greater on prenatal sonography.…”

mentioning

confidence: 99%

Gastroschisis: can sonography of the fetal bowel accurately predict postnatal outcome?

Babcook

Hedrick

Goldstein

et al. 1994

Journal of Ultrasound in Medicine

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To determine whether prenatal sonographic features of the small bowel can accurately predict postnatal outcome in fetuses with gastroschisis, the sonograms of 24 fetuses with prenatally detected gastroschisis were retrospectively reviewed for fetal bowel features including small bowel dilatation and bowel wall thickening. To identify a relationship between the sonographic features and neonatal outcome, each feature was analyzed against eight adverse clinical outcome measures including bowel obstruction or atresia, necrosis, and need for bowel resection, using chi‐square analysis and Kendall's taub correlation. When a relationship was identified, the sensitivity and specificity of the sonographic feature for predicting adverse outcome were determined. Only maximum small bowel diameter was related to postnatal bowel complications. Significantly more fetuses with a maximum small bowel diameter of greater than 11 mm (7/12) had bowel complications than did fetuses with MBD 11 mm or less (2/12) P < 0.05). Using a cutoff point of greater than 11 mm for maximum small bowel diameter, the sensitivity was 78%, specificity 66%, and positive predictive value 71% for predicting postnatal bowel complications. However, in only seven of 24 cases did the two observers make the same maximum small bowel diameter measurement, and in 14 of 24 cases their measurements differed by 2 mm or more. The observers varied sufficiently in their measurements to shift three fetuses (13%) between categories (< or = 11 mm or > 11 mm). Although a maximum small bowel diameter of 11 mm stratified our fetuses, this measurement may not be clinically meaningful.

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Ultrasonographic assessment of intestinal damage in with gastroschisis: Is it of clinical value?

Cited by 47 publications

References 8 publications

Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome?

Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome?

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

Gastroschisis: can sonography of the fetal bowel accurately predict postnatal outcome?

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