Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy
| Autor: | Alina Weissmann-Brenner, Anya Kushnir, Boaz Weisz, Shir Shust-Barequet, T. Weissbach, Eran Kassif, Tal Elkan-Miller, Ram Mazkereth, Reuwen Achiron |
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| Rok vydání: | 2020 |
| Předmět: |
Polyhydramnios
medicine.medical_specialty Pregnancy Trimester Third Prenatal diagnosis Tracheoesophageal fistula Ultrasonography Prenatal Fetal Development 03 medical and health sciences 0302 clinical medicine Esophagus Fetus Obstetrics and gynaecology Predictive Value of Tests Pregnancy medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Longitudinal Studies Esophageal Atresia Retrospective Studies 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology business.industry Stomach Obstetrics and Gynecology General Medicine medicine.disease Reproductive Medicine Atresia Pregnancy Trimester Second embryonic structures Gestation Female Radiology business Tracheoesophageal Fistula |
| Zdroj: | Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and GynecologyREFERENCES. 58(1) |
| ISSN: | 1469-0705 |
| Popis: | Objective Esophageal atresia and/or tracheoesophageal fistula (EA/TEF) remains one of the most frequently missed congenital anomalies prenatally. The aim of our study was to elucidate the sonographic manifestation of EA/TEF throughout pregnancy. Methods This was a retrospective study of data obtained from a tertiary center over a 12-year period. The prenatal ultrasound scans of fetuses with EA/TEF were assessed to determine the presence and timing of detection of three principal signs: small/absent stomach and worsening polyhydramnios, both of which were considered as 'suspected' EA/TEF, and esophageal pouch, which was considered as 'detected' EA/TEF. We assessed the yield of the early (14-16 weeks' gestation), routine mid-trimester (19-26 weeks) and third-trimester (≥ 27 weeks) anomaly scans in the prenatal diagnosis of EA/TEF. Results Seventy-five cases of EA/TEF with available ultrasound images were included in the study. A small/absent stomach was detected on the early anomaly scan in 3.6% of fetuses scanned, without a definitive diagnosis. On the mid-trimester scan, 19.4% of scanned cases were suspected and 4.3% were detected. On the third-trimester anomaly scan, 43.9% of scanned cases were suspected and 33.9% were detected. An additional case with an esophageal pouch was detected on magnetic resonance imaging (MRI) in the mid-trimester and a further two were detected on MRI in the third trimester. In total, 44.0% of cases of EA/TEF in our cohort were suspected, 33.3% were detected and 10.7% were suspected but, eventually, not detected prenatally. Conclusions Prenatal diagnosis of EA/TEF on ultrasound is not feasible before the late second trimester. A small/absent stomach may be visualized as early as 15 weeks' gestation. Polyhydramnios does not develop before the mid-trimester. An esophageal pouch can be detected as early as 22 weeks on a targeted scan in suspected cases. The detection rates of all three signs increase with advancing pregnancy, peaking in the third trimester. The early and mid-trimester anomaly scans perform poorly as a screening and diagnostic test for EA/TEF. © 2020 International Society of Ultrasound in Obstetrics and Gynecology. |
| Databáze: | OpenAIRE |
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