Prenatal intraabdominal bowel dilation is associated with postnatal gastrointestinal complications in fetuses with gastroschisis

Am J Obstet Gynecol. 2010 Apr;202(4):396.e1-6. doi: 10.1016/j.ajog.2009.10.888. Epub 2009 Dec 30.

Abstract

Objective: The purpose of this study was to determine whether prenatal intraabdominal bowel dilation (IBD) is associated with increased postnatal complications in fetuses with gastroschisis.

Study design: A retrospective review was performed on all maternal-fetus pairs with prenatally diagnosed gastroschisis that was treated at the University of California San Francisco from 2002-2008. Postnatal outcomes were compared between fetuses with and without IBD.

Results: Forty-three of 61 maternal-fetal pairs met the criteria for inclusion. Sixteen fetuses (37%) had evidence of IBD. Fetuses with IBD were significantly more likely to have postnatal bowel complications (38% vs 7%; P = .037). The presence of multiple loops of IBD (n = 6) as opposed to a single loop (n = 10) was associated highly with bowel complications and increased time to full enteral feeding and length of hospital stay (100% vs 0% [P = .001]; 44 vs 23 days [P = .034]; 69 vs 27 days [P = .001], respectively).

Conclusion: IBD is associated with increased postnatal complications in infants with prenatally diagnosed gastroschisis; however, this association seems to be limited to those with multiple loops of dilated intraabdominal bowel.

MeSH terms

  • Abdominal Wall / abnormalities*
  • Abdominal Wall / diagnostic imaging
  • Adult
  • Female
  • Fetal Diseases / diagnostic imaging*
  • Fetal Diseases / mortality
  • Gastrointestinal Diseases / mortality
  • Gastrointestinal Diseases / pathology*
  • Gastroschisis / diagnostic imaging*
  • Gastroschisis / mortality
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / mortality
  • Infant, Newborn, Diseases / pathology*
  • Intestines / abnormalities*
  • Intestines / diagnostic imaging
  • Length of Stay / statistics & numerical data
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Severity of Illness Index
  • Ultrasonography, Prenatal
  • Young Adult