M Kuleva1, N Khen-Dunlop, Y Dumez, Y Ville, L J Salomon. 1. Department of Obstetrics, Hôpital Necker Enfants Malades, Assistance Publique, Hôpitaux de Paris, Université Paris Descartes Société Française pour l'Amélioration des Pratiques Echographiques, Paris, France.
Abstract
OBJECTIVE: To establish a correlation between prenatal ultrasound findings and postnatal outcome in neonates with gastroschisis (GS). DESIGN: Retrospective case-control study. SETTING: Prenatal ultrasound reports, labour and neonatal intensive care unit notes, and paediatric surgical clinic records were reviewed. POPULATION: Neonates with an antenatal diagnosis of isolated GS. METHODS: The neonates were divided into two groups: one with associated bowel complications including intestinal atresia, perforation, necrosis or volvulus ('complex' GS), and the second without bowel complication ('simple' GS). Prenatal ultrasound markers: small-for-gestational-age, intra-abdominal and extra-abdominal bowel dilatation (>6 mm), thickened intestinal wall and stomach dilatation were correlated with outcome. MAIN OUTCOME MEASURES: Fetal or neonatal death in complex versus simple GS. Time on parenteral nutrition and duration of hospital stay were also noted. RESULTS: In all, 105 cases were eligible for analysis. Survival rate was 101/105 (96.2%). None of the ultrasound markers was predictive of fetal or neonatal death. Fourteen of 103 live-born babies (14.6%) had complex GS, which was associated with longer time on parenteral nutrition [8.0 (51.5-390) versus 33.5 (25.3-53.3) days, P<0.001] and longer duration of hospital stay [85.3 (55.5-210) versus 41.5 (33.0-64.8) days, P<0.001]. Infants with complex GS were more likely to require bowel resection and stoma placement (P<0.05). Intra-abdominal bowel dilatation was the only predictive ultrasound marker of complex GS (odds ratio 4.13, 95% CI 1.32-12.90; P=0.018). Receiver operating characteristic curve for observed/expected bowel diameter yielded 6 as the cutoff value for predicting complex GS (odds ratio 7.9, 95% CI 2.3-27.3; P=0.001) with 54% and 88% for sensibility and specificity, respectively. CONCLUSIONS: Intra-abdominal bowel dilatation is the only ultrasound marker predictive of complex GS but it is a strong marker.
OBJECTIVE: To establish a correlation between prenatal ultrasound findings and postnatal outcome in neonates with gastroschisis (GS). DESIGN: Retrospective case-control study. SETTING: Prenatal ultrasound reports, labour and neonatal intensive care unit notes, and paediatric surgical clinic records were reviewed. POPULATION: Neonates with an antenatal diagnosis of isolated GS. METHODS: The neonates were divided into two groups: one with associated bowel complications including intestinal atresia, perforation, necrosis or volvulus ('complex' GS), and the second without bowel complication ('simple' GS). Prenatal ultrasound markers: small-for-gestational-age, intra-abdominal and extra-abdominal bowel dilatation (>6 mm), thickened intestinal wall and stomach dilatation were correlated with outcome. MAIN OUTCOME MEASURES: Fetal or neonatal death in complex versus simple GS. Time on parenteral nutrition and duration of hospital stay were also noted. RESULTS: In all, 105 cases were eligible for analysis. Survival rate was 101/105 (96.2%). None of the ultrasound markers was predictive of fetal or neonatal death. Fourteen of 103 live-born babies (14.6%) had complex GS, which was associated with longer time on parenteral nutrition [8.0 (51.5-390) versus 33.5 (25.3-53.3) days, P<0.001] and longer duration of hospital stay [85.3 (55.5-210) versus 41.5 (33.0-64.8) days, P<0.001]. Infants with complex GS were more likely to require bowel resection and stoma placement (P<0.05). Intra-abdominal bowel dilatation was the only predictive ultrasound marker of complex GS (odds ratio 4.13, 95% CI 1.32-12.90; P=0.018). Receiver operating characteristic curve for observed/expected bowel diameter yielded 6 as the cutoff value for predicting complex GS (odds ratio 7.9, 95% CI 2.3-27.3; P=0.001) with 54% and 88% for sensibility and specificity, respectively. CONCLUSIONS:Intra-abdominal bowel dilatation is the only ultrasound marker predictive of complex GS but it is a strong marker.
Authors: K R Goetzinger; M G Tuuli; R E Longman; K M Huster; A O Odibo; A G Cahill Journal: Ultrasound Obstet Gynecol Date: 2014-03-03 Impact factor: 7.299
Authors: C C M M Lap; L R Pistorius; E J H Mulder; M Aliasi; W L M Kramer; C M Bilardo; T E Cohen-Overbeek; E Pajkrt; D Tibboel; R M H Wijnen; G H A Visser; G T R Manten Journal: Ultrasound Obstet Gynecol Date: 2020-06 Impact factor: 7.299
Authors: Annelieke Hijkoop; Chiara C M M Lap; Moska Aliasi; Eduard J H Mulder; William L M Kramer; Hens A A Brouwers; Robertine van Baren; Eva Pajkrt; Anton H van Kaam; Caterina M Bilardo; Lourens R Pistorius; Gerard H A Visser; René M H Wijnen; Dick Tibboel; Gwendolyn T R Manten; Titia E Cohen-Overbeek Journal: Prenat Diagn Date: 2019-10-25 Impact factor: 3.050