Abstract
The aim of this study was to find a prenatal parameter to be able to predict possible prenatal complications or postnatal surgical options, thus allowing the fetal medicine specialist, together with pediatric surgeons and neonatologists, to improve the counseling of the parents and to determine the timing of delivery and therapy. This was a retrospective analysis of prenatal diagnosis and outcome of fetuses with 34 cases of gastroschisis between the years 2007 and 2017. A total of 34 fetuses with gastroschisis were examined and 33 outcomes registered: 22 cases of simple gastroschisis (66.7%) and 11 cases of complex gastroschisis (33.3%). A cut-off value of 18 mm for intraabdominal bowel dilatation (IABD) showed a positive predictive value (PPV) of 100% for predicting simple gastroschisis. IABD gives the best prediction for simple versus complex gastroschisis (cut-off of 18 mm). Extra-abdominal bowel dilatation (EABD) cut-off values of 10 mm and 18 mm showed low sensitivity and specificity to predict complex gastroschisis.
Highlights
IntroductionOne of the most commonly seen abdominal wall defects of the newborn is gastroschisis
One of the most commonly seen abdominal wall defects of the newborn is gastroschisis.Gastroschisis is a right-sided paraumbilical abdominal wall defect which causes the herniation of the bowel, which floats in amniotic fluid
The associated complications are mostly in the gastrointestinal area, seen as intestinal obstruction or atresia [5,6], and are defined as complex gastroschisis compared to simple gastroschisis without complications
Summary
One of the most commonly seen abdominal wall defects of the newborn is gastroschisis. Gastroschisis is a right-sided paraumbilical abdominal wall defect which causes the herniation of the bowel, which floats in amniotic fluid. The lateral abdominal walls probably fail to fuse at the embryological period until 5 weeks into pregnancy [1]. The prevalence of gastroschisis is 3.8 to 4.5 per 10,000 births [2,3], but there has been an increase in the number of cases in the last few decades [4]. The associated complications are mostly in the gastrointestinal area, seen as intestinal obstruction or atresia [5,6], and are defined as complex gastroschisis compared to simple gastroschisis without complications. Chromosomal abnormalities or co-morbidities are seen rarely [7]. A multidisciplinary collaboration, with regular meetings between fetal medicine specialists, obstetricians, neonatologists and pediatric surgeons, is needed for the diagnosis, counseling the parents, ultrasound controls and decision making about the time of delivery
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