What prenatal ultrasound features are predictable of complex or vanishing gastroschisis? A retrospective study

• Published in: Prenatal diagnosis Vol. 37; no. 2; pp. 168 - 175
• Main Authors: Geslin, Dorothée, Clermidi, Pauline, Gatibelza, Marie‐Eve, Boussion, Françoise, Saliou, Anne‐Hélène, Le Manac'h Dove, Gaëlle, Margaryan, Marc, De Vries, Philine, Sentilhes, Loïc, Levard, Guillaume, Lardy, Hubert, Arnaud, Alexis, Leclair, Marc‐David, Podevin, Guillaume, Schmitt, Françoise
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-02-2017
• Subjects: Abdomen; Abdomen - diagnostic imaging; Abdomen - pathology; Abdominal wall; Adult; Complications; Defects; Dilatation, Pathologic; Dilation; Female; Fetal Development; Fetuses; Gastroschisis - diagnosis; Gastroschisis - epidemiology; Gastroschisis - pathology; Humans; Infant, Newborn; Intestine; Intestines - diagnostic imaging; Intestines - pathology; Pregnancy; Pregnancy Outcome - epidemiology; Prenatal development; Prognosis; Remission, Spontaneous; Retrospective Studies; Stomach; Ultrasonic imaging; Ultrasonography, Prenatal - statistics & numerical data; Ultrasound; Young Adult
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.4984

Objective
To evaluate prenatal ultrasound parameters as prognostic factors for complex and vanishing gastroschisis.
Methods
Retrospective multicentre study of 200 gastroschisis over 13 years (2000–2013). Collection of prenatal ultrasound evaluation on maternal and fetal growth parameters, intra‐ and extra‐abdominal bowel and stomach dilation, abdominal wall defect diameter and changes in bowel appearance. Correlation of these factors with the presence of mechanical intestinal complications at birth, named ‘complex gastroschisis’.
Results
Fifty‐two patients (26%) had complex gastroschisis (CG), including ten vanishing gastroschisis. The presence of intra‐abdominal bowel dilation at the second (T2) or third (T3) trimester ultrasound was predictive for CG, with odds ratios at 6.69 (95%CI 2.41–18.55) and 4.72 (95%CI 2.16–10.28), respectively, with a cut‐off value at the last examination of >19 mm. A small abdominal wall defect diameter was also predictive for CG, with cut‐off values of <9.2 mm at T2 and <12.5 mm at T3. Vanishing gastroschisis recorded earlier intra‐abdominal bowel dilation diagnosis, associated with a small wall defect and no extra‐abdominal dilation.
Conclusion
Intra‐abdominal bowel dilation and a small abdominal wall defect diameter accurately predict CG and could be a first sign of vanishing gastroschisis when they occur early. © 2016 John Wiley & Sons, Ltd.
WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?
Prenatal ultrasound intra‐abdominal bowel dilation may be a prognostic factor for complex gastroschisis.
WHAT DOES THIS STUDY ADD?
We confirm the intra‐abdominal bowel dilation and add the wall defect diameter as prognostic factor for complex gastroschisis, and provide cut‐off values for both features, depending from the term. Moreover, we specifically consider the particular entity of vanishing gastroschisis.