Document Detail


Does gastric dilation predict adverse perinatal or surgical outcomes in fetuses with gastroschisis?
MedLine Citation:
PMID:  21031347     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To compare perinatal and infant surgical outcomes in fetuses with/without gastric dilation in a single centre cohort. METHODS: Retrospective study of all singleton pregnancies with a prenatal diagnosis of gastroschisis managed at University of Toronto perinatal centres (Jan 2001-Feb 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/without gastric dilation including: gestational age, mode of delivery, indication for Cesarean section, meconium-stained amniotic fluid, birth weight percentile, Apgar scores at 1 and 5 minutes, 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 were managed at our center, of whom 32 (33%) 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 outcomes. 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 (FGD) was associated with meconium-stained amniotic fluid at delivery, but was 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.
Authors:
M A Alfaraj; G Ryan; J C Langer; R Windrim; Pgr Seaward; J Kingdom
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-10-28
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada.
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