Ultrasound markers for prediction of complex gastroschisis and adverse outcome: longitudinal prospective nationwide cohort study.
Abdomen
/ embryology
Biomarkers
/ analysis
Biometry
Diagnosis, Differential
Female
Fetal Death
/ etiology
Fetus
/ diagnostic imaging
Gastroschisis
/ diagnostic imaging
Gestational Age
Humans
Infant, Newborn
Intestines
/ embryology
Linear Models
Logistic Models
Longitudinal Studies
Mesenteric Artery, Superior
/ embryology
Polyhydramnios
/ diagnostic imaging
Predictive Value of Tests
Pregnancy
Prospective Studies
Pulsatile Flow
Risk Assessment
Stillbirth
Ultrasonography, Prenatal
/ statistics & numerical data
bowel
gastroschisis
intra-abdominal bowel diameter
mesenteric artery
ultrasound
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
30
11
2018
revised:
18
09
2019
accepted:
19
09
2019
pubmed:
16
10
2019
medline:
27
11
2021
entrez:
16
10
2019
Statut:
ppublish
Résumé
To identify antenatal ultrasound markers that can differentiate between simple and complex gastroschisis and assess their predictive value. This was a prospective nationwide study of pregnancies with isolated fetal gastroschisis that underwent serial longitudinal ultrasound examination at regular specified intervals between 20 and 37 weeks' gestation. The primary outcome was simple or complex (i.e. involving bowel atresia, volvulus, perforation or necrosis) gastroschisis at birth. Fetal biometry (abdominal circumference and estimated fetal weight), the occurrence of polyhydramnios, intra- and extra-abdominal bowel diameters and the pulsatility index (PI) of the superior mesenteric artery (SMA) were assessed. Linear mixed modeling was used to compare the individual trajectories of cases with simple and those with complex gastroschisis, and logistic regression analysis was used to estimate the strength of association between the ultrasound parameters and outcome. Of 104 pregnancies with isolated fetal gastroschisis included, four ended in intrauterine death. Eighty-one (81%) liveborn infants with simple and 19 (19%) with complex gastroschisis were included in the analysis. We found no relationship between fetal biometric variables and complex gastroschisis. The SMA-PI was significantly lower in fetuses with gastroschisis than in healthy controls, but did not differentiate between simple and complex gastroschisis. Both intra- and extra-abdominal bowel diameters were larger in cases with complex, compared to those with simple, gastroschisis (P < 0.001 and P < 0.005, respectively). The presence of intra-abdominal bowel diameter ≥ 97.7 This large prospective longitudinal study found that intra-abdominal bowel dilatation when present repeatedly during fetal development can differentiate between simple and complex gastroschisis; however, the positive predictive value is low, and therefore the clinical usefulness of this marker is limited. © 2019 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Identifiants
pubmed: 31613023
doi: 10.1002/uog.21888
pmc: PMC7318303
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
776-785Investigateurs
C J Bax
(CJ)
R van Baren
(R)
H A A Brouwers
(HAA)
P H Dijk
(PH)
A H van Kaam
(AH)
C Koopman-Esseboom
(C)
E Sikkel
(E)
M C Haak
(MC)
A F van Heijst
(AF)
A F van der Hoeven
(AF)
E L van Heurn
(EL)
C Sleeboom
(C)
M M van Weissenbruch
(MM)
C Willekes
(C)
Informations de copyright
© 2019 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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