Gabriele Tonni1, Gianpaolo Grisolia2, Roberta Granese3, Annamaria Giacobbe3, Marcello Napolitano4, Jurandir Piassi Passos5, Edward Araujo Júnior5. 1. a Department of Obstetrics & Gynecology , Guastalla Civil Hospital , AUSL Reggio Emilia, Reggio Emilia , Italy . 2. b Department of Obstetrics & Gynecology , Hospital "C. Poma", Mantua , Italy . 3. c Department of Pediatric , Gynecological, Microbiological and Biomedical Sciences, Università Degli Studi Di Messina , Messina , Italy . 4. d Department of Radiology and Neuroradiology , Istituti Clinici Di Perfezionamento , "V. Buzzi", Milan , Italy , and. 5. e Department of Obstetrics , Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP) , São Paulo-SP , Brazil.
Abstract
OBJECTIVE: To describe seven cases of gastrointestinal tract (GIT) obstructions and to report a skewed review of the literature. METHODS: We performed a search of our permanent perinatal database about cases with prenatal ultrasound and MRI diagnosis of gastrointestinal tract obstructions between 2006 and 2013. All cases were followed until hospital discharge and pre-natal diagnosis were confirmed by fetal MRI, postnatal imaging and/or intra-operative findings. Maternal age, parity, gestational age at diagnosis, ultrasound findings, gestational age at delivery, Apgar scores at 1 and 5 min and postnatal outcome have been recorded. RESULTS: We identified seven cases of gastric and small bowel atresia. Karyotype was normal in six cases and abnormal in one co-twin [46,XY dup (20) (qq13.1q13.3)dn] of a dichorionic-diamniotic pregnancy. The mean ± SD for maternal age, gestational age at diagnosis, gestational at delivery, birth weight and Apgar scores at 1 and 5 min were 30.8 ± 4.8 years, 29.8 ± 3.7 weeks, 2507.5 ± 727.5 g and 5.6 ± 2.1, 7.6 ± 1.6, respectively. All fetuses' undergone surgical procedures in the postnatal period and all of them were discharged live from the hospital. CONCLUSION: Prompted antenatal detection of gastrointestinal tract obstruction using ultrasound proved to be diagnostic in all cases. Fetal MRI aid was a useful complementary diagnostic investigation. Correct pre-natal diagnosis allows adequate counseling, delivery planning and management care by a multidisciplinary team.
OBJECTIVE: To describe seven cases of gastrointestinal tract (GIT) obstructions and to report a skewed review of the literature. METHODS: We performed a search of our permanent perinatal database about cases with prenatal ultrasound and MRI diagnosis of gastrointestinal tract obstructions between 2006 and 2013. All cases were followed until hospital discharge and pre-natal diagnosis were confirmed by fetal MRI, postnatal imaging and/or intra-operative findings. Maternal age, parity, gestational age at diagnosis, ultrasound findings, gestational age at delivery, Apgar scores at 1 and 5 min and postnatal outcome have been recorded. RESULTS: We identified seven cases of gastric and small bowel atresia. Karyotype was normal in six cases and abnormal in one co-twin [46,XY dup (20) (qq13.1q13.3)dn] of a dichorionic-diamniotic pregnancy. The mean ± SD for maternal age, gestational age at diagnosis, gestational at delivery, birth weight and Apgar scores at 1 and 5 min were 30.8 ± 4.8 years, 29.8 ± 3.7 weeks, 2507.5 ± 727.5 g and 5.6 ± 2.1, 7.6 ± 1.6, respectively. All fetuses' undergone surgical procedures in the postnatal period and all of them were discharged live from the hospital. CONCLUSION: Prompted antenatal detection of gastrointestinal tract obstruction using ultrasound proved to be diagnostic in all cases. Fetal MRI aid was a useful complementary diagnostic investigation. Correct pre-natal diagnosis allows adequate counseling, delivery planning and management care by a multidisciplinary team.
Authors: Bridgette M McCormick; Karin J Blakemore; Clark T Johnson; Juliet C Bishop; Eric B Jelin; Jeanne M Miklos; Angie C Jelin Journal: Am J Obstet Gynecol MFM Date: 2020-10-29