OC26.01: First trimester screening for preterm birth

Abstract

Objectives: The morbidity of infants with largely depends on coexisting intestinal anomalies such as intestinal atresia, stenosis, perforation, necrosis or volvulus. We aimed to establish a correlation between prenatal ultrasound findings and postnatal outcome in foetuses with gastroschisis. Methods: A retrospective review of antenatal cases of isolated gastroschisis referred to our centre from 1999 to 2010 was carried out. The following prenatal ultrasound markers were analysed for their correlation with bowel complications: the presence of IUGR ( 6 mm), thickened intestinal wall (>3 mm), stomach dilatation. The postnatal outcome was obtained and the neonates were divided into two groups: 1st group with associated bowel anomalies (‘‘complex’’ group), 2nd group without bowel anomalies (‘‘simple’’ group). The outcome measures were: the time on parenteral nutrition (TPN), the length of hospital stay (LHS), foetal or neonatal death. Results: Over a 12-year period there were 109 cases of gastroschisis followed in our unit. One hundred and five cases were eligible for analysis. Survival rate was 101/105 (96.2%). There were two neonatal deaths and two intrauterine foetal demises. None of the ultrasound markers was predictive of foetal or neonatal death. Fifteen of 103 live-born babies (14.6%) had ‘‘complex’’ gastroschisis. The median TPN in this group was 102 days (range 22–1095) and the median LHS 110 days (range 29–450) compared to median TPN 34 days (range 10–360) and median LHS 42 days (range 20–225) in the simple gastroschisis group (P < 0.05). The only ultrasound marker predictive of ‘‘complex’’ gastroschisis was intraabdominal bowel dilation (OR = 2.8 [95% CI 1.07–7.36] P = 0.037. Conclusions: Infants with ‘‘complex gastroschisis’’ are likely to have substantial morbidity and worse outcome. The only ultrasound marker predictive of ‘‘complex’’ gastroschisis is intra-abdominal bowel dilation. OC25.04 2D sonographic evaluation of the fetal palate