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Prenatal sonographic ultrasound predictors for the outcome in fetal gastroschisis: a retrospective analysis

  • Maternal-Fetal Medicine
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To identify predictive ultrasound signs for unfavorable outcome in fetal gastroschisis (GS).

Methods

This is a retrospective cohort study among pregnant women with the prenatal diagnosis of GS between 1998 and 2011 at the University of Wuerzburg, Germany. Analysis included prenatal ultrasound scans, neonatal intensive care unit (NICU) records, and pediatric records. The collected variables included maternal and fetal demographics, as well as an analysis of predictors for unfavorable fetal outcome. Unfavorable outcome was defined by more than 2 postnatal surgical interventions, intestinal resections, and long time to oral feeding (≥4 weeks).

Results

35 cases of fetal GS were diagnosed, whereby 23 cases met the inclusion criteria and were evaluated by prenatal ultrasound and postnatal outcome. Based on the postnatal situation, 15 patients were classified in a good prognosis group and 8 patients in a poor prognosis group. Fetuses with poor prognosis were presented later during pregnancy (21.1 ± 6 vs. 26.9 ± 5.3 weeks; p < 0.01) and delivered at earlier gestational age (35.6 ± 0.8 vs. 33.4 ± 1.4 weeks; p < 0.01) with lower birth weight (2074 ± 306.3 vs. 2559 ± 255.4 g; p < 0.01). There were no differences in prenatal findings like growth restriction, amniotic fluid index, or Doppler results between good and poor prognosis group. However, early detected and long-lasting bowel dilatation was associated with poor prognosis.

Conclusion

Late presentation and early gestational age at delivery are associated with poor prognosis in neonates with GS. Furthermore, early onset as well as long duration of bowel dilatation is associated with poor fetal outcome, while other ultrasound characteristics are not able to predict poor prognosis of GS.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany

    Tanja Nadine Stüber, Claire Weiß, Ursula Zollner, Achim Wöckel & Monika Rehn

  2. Children`s Hospital, University of Wuerzburg, Josef-Schneider-Str. 2, 97080, Wuerzburg, Germany

    Eric Frieauff

  3. Department of Paediatric Surgery, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany

    Thomas Meyer

Authors
  1. Tanja Nadine Stüber
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  2. Eric Frieauff
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  3. Claire Weiß
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  4. Ursula Zollner
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  5. Achim Wöckel
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  6. Thomas Meyer
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  7. Monika Rehn
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Corresponding author

Correspondence to Tanja Nadine Stüber.

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The authors declare that there is no potential conflict of interest.

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Stüber, T.N., Frieauff, E., Weiß, C. et al. Prenatal sonographic ultrasound predictors for the outcome in fetal gastroschisis: a retrospective analysis. Arch Gynecol Obstet 293, 1001–1006 (2016). https://doi.org/10.1007/s00404-015-3936-2

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  • DOI: https://doi.org/10.1007/s00404-015-3936-2

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