Does gastric dilation predict adverse perinatal or surgical outcome in fetuses with gastroschisis?
| Autor: | Malikah A. Alfaraj, Greg Ryan, P. G. R. Seaward, John Kingdom, Rory Windrim, Jacob C. Langer |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Amniotic fluid medicine.medical_treatment Prenatal diagnosis Gestational Age Gastric Dilatation Ultrasonography Prenatal Predictive Value of Tests Pregnancy medicine Humans Radiology Nuclear Medicine and imaging Retrospective Studies Gastroschisis Radiological and Ultrasound Technology Obstetrics business.industry Cesarean Section Infant Newborn Obstetrics and Gynecology Gestational age Retrospective cohort study General Medicine Bowel resection medicine.disease Delivery Obstetric Surgery Intestines Treatment Outcome Reproductive Medicine Atresia Apgar Score Apgar score Female business Dilatation Pathologic |
| Zdroj: | Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 37(2) |
| ISSN: | 1469-0705 |
| Popis: | Objective To compare perinatal and infant surgical outcomes in fetuses with gastroschisis with and without gastric dilation in a single-center cohort. Methods This was a retrospective study of all singleton pregnancies with a prenatal diagnosis of gastroschisis managed at University of Toronto perinatal centers between January 2001 and February 2010. Digital prenatal ultrasound images were reviewed to determine fetal gastric size within 2 weeks of delivery. Perinatal and surgical outcomes were compared in fetuses with and without gastric dilation including: gestational age at delivery, mode of delivery, indication for Cesarean section, meconium-stained amniotic fluid, birth weight percentile, Apgar scores at 1 and 5 min, umbilical artery pH, time to full enteral feeding, length of hospital stay, bowel atresia or necrosis and need for bowel resection. Results Ninety-eight fetuses with prenatally diagnosed gastroschisis managed at our center were included in the study, of which 32 (32.7%) were found to have gastric dilation. Gastric dilation predicted meconium-stained amniotic fluid at delivery (53% vs. 24%; P = 0.017), but no other adverse perinatal outcome. Surgical morbidity rates (bowel atresia, bowel necrosis, perforation diagnosed postnatally, need for bowel resection, total time to full enteral feeding and length of hospital stay) were unaffected by gastric dilation. Conclusions In gastroschisis, fetal gastric dilation is associated with meconium-stained amniotic fluid at delivery, but is not predictive of any serious perinatal or postnatal complications. Fetal growth and well-being should be serially evaluated on ultrasound using biophysical and Doppler assessment to decide on the optimal timing and mode of delivery. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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