Document Detail


Persistent non-visualisation of the fetal stomach: diagnostic and prognostic implications.
MedLine Citation:
PMID:  20538709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
DESIGN: All fetuses diagnosed with 'absent stomach' at anomaly screening over an 8-year period were identified using the University College Hospital fetal medicine database. These were cross-referenced with records from the paediatric surgical unit at Great Ormond Street Hospital and pathology department at University College Hospital to ascertain postnatal or postmortem diagnosis and outcome in each case.
RESULTS: Of the 84 cases identified, eight were found to have normal stomachs on subsequent antenatal scans, while 76 had persistent non-visualisation of the stomach. Underlying diagnoses included 24 gastro-intestinal tract and/or respiratory anomalies, 22 aneuploidies, six neuromuscular syndromes, three central nervous system anomalies, seven renal anomalies and five genetic syndromes. Seven cases had no identifiable postnatal abnormalities, 26 pregnancies were terminated and nine fetuses died in utero. Of the 33 live births, eight died in the neonatal period and three died in infancy. Only 28 survived into childhood. Two patients were lost to follow up.
CONCLUSIONS: Persistent non-visualisation of the fetal stomach in the antenatal period was associated with a wide range of underlying diagnoses. In many cases, prognosis was poor. Only 37% of pregnancies resulted in liveborn infants surviving more than 6 months. The incidence of an abnormal karyotype was 29%. Diagnosis and outcome was normal in only 9.2% of cases. We propose an algorithm for the management of persistent non-visualisation of the fetal stomach on antenatal ultrasound.
Authors:
Alastair McKelvey; Joanna Stanwell; Naima Smeulders; Reza Nasr; Joseph Curry; Pranav Pandya
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Publication Detail:
Type:  Journal Article     Date:  2010-06-10
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-27     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F439-42     Citation Subset:  AIM; IM    
Affiliation:
Fetal Medicine Unit, Elizabeth Garrett Anderson Wing, University College Hospital, London, UK. alastairmckelvey@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / ultrasonography
Algorithms
Aneuploidy
Female
Gestational Age
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome
Prognosis
Prospective Studies
Stomach / abnormalities*,  radiography,  ultrasonography*
Syndrome
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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