Congenital Gastrointestinal Anomalies Research Articles

Evidence-based advances in minimally invasive surgery in infants with congenital gastrointestinal anomalies: a narrative review.

Minimally invasive surgery (MIS) has been widely utilized to manage congenital gastrointestinal (GI) anomalies in children during the last two decades. Currently, MIS has a proven track-record for its feasibility and provides multiple benefits including better cosmesis, less trauma, and faster recovery in neonates and infants. However, it remains controversial whether MIS provides better definitive outcomes in pediatric patients with GI anomalies, especially among neonates. We aim to review the recent developments of MIS in infants with GI defects, assisting surgeons in making decisions and improving patient outcomes. A comprehensive literature search of PubMed and Web of Science's core collection was performed using terms of MIS techniques and congenital GI anomalies. This review summarizes recent evidence-based advances of MIS in infants with congenital GI defects and potential future strategies based on evidence. Better cosmetic results, less postoperative pain, and an accelerated recovery have been shown to be common advantages of MIS relative to open approaches. Technical hurdles and metabolic disturbance were reported to be the main reasons for the decisions of open approach. Advanced techniques of MIS have made more precise manipulations and better outcomes possible, even for newborns. At the same time, surgeons should not be afraid to use an open approach in certain circumstances due to technical limitations or patient tolerance. The difficulty infants face in expressing their true feelings underscores the need for systematic and objective assessment tools to evaluate surgical outcomes.

Trends in Prenatal Diagnosis of Congenital Gastrointestinal Anomalies: A Cohort Study

Trends in Prenatal Diagnosis of Congenital Gastrointestinal Anomalies: A Cohort Study

Mental Health Outcomes of Mothers of Children With Congenital Gastrointestinal Anomalies Are Similar to Control Mothers: A Longitudinal Retrospective Cohort Study

PurposeMothers of infants born with congenital gastrointestinal surgical anomalies experience a unique caregiving role. Whether these challenges result in more mental health diagnoses than the general population is unknown. This study assessed mental health diagnoses in mothers of children born with congenital surgical anomalies (CSA) compared to mothers of children without CSA. MethodsA total of 780 mothers of children with CSA (case-mothers) and 6994 control-mothers were included. Mental health diagnoses were obtained using International Classification of Diseases 9 codes from an administrative database. Multivariate hazard ratios (HR) of mental health diagnoses were determined for mothers following childbirth, controlling for socioeconomic status, mental health diagnoses prior to childbirth, and age at childbirth. Subgroup analyses were completed for anxiety, depression, and post-traumatic stress disorder (PTSD). The association between a woman's mental health history and becoming a case-mother was analyzed using risk ratios (RR). ResultsCase-mothers were not at increased risk of mental health disorders compared to controls (HR = 1.00; CI95 = 0.92–1.09). In aggregate analysis, no increased risk of anxiety, depression, or PTSD was found. Subgroup analyses revealed that congenital diaphragmatic hernia case-mothers had an increased risk of depression (HR = 1.43; CI95 = 1.08–1.88). No other case-mothers were at increased risk of mental health diagnoses, anxiety, depression, or PTSD. Only omphalocele was associated with mental health diagnoses before childbirth (RR = 1.89; CI95 = 1.58–2.26). ConclusionsCollectively, mothers of children with CSAs did not have a greater risk of a mental health disorder, anxiety, depression, or PTSD compared to control-mothers. Only mothers of children with congenital diaphragmatic hernia had an increased risk of depression. Level of evidenceII.

Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates?

COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.

Experiences and needs of parents of babies treated for congenital duodenal obstruction – A qualitative study

BackgroundKnowledge about experiences and needs of parents of babies operated for congenital gastrointestinal anomalies in the neonatal period is very limited. Therefore, we performed this qualitative study to explore the experiences and needs in this group of parents. MethodsParents of babies operated for congenital duodenal obstruction participated in a focus group discussion. The focus group discussion was analyzed with hermeneutical interpretation, and themes representing important areas to the parents were identified. ResultsSix parents of five babies participated. Four themes evolved from the focus group discussion. “Grief over loss of initial parent-child bonding” describes the feeling of being separated from the baby during initial treatment. “Let me take care of my baby” refers to the importance for the parents to be involved in caring for their baby. “Concerns about breastfeeding” reflects the mothers’ worries about and need for encouragement and guidance regarding pumping and breastfeeding. “Trusting health care providers” implies that the parents were confident that their baby was well taken care of, despite an emotionally stressful situation. ConclusionsThis qualitative study provides new and important knowledge regarding the experiences and needs of parents of babies operated for congenital duodenal obstruction. The results may be generalizable to other gastrointestinal anomalies needing surgery. This new knowledge may help health care providers to better meet the needs in parents of a baby having undergone repair of gastrointestinal anomaly. Level of evidenceIV

Gastrointestinal congenital anomalies requiring surgery: diagnosis, counselling, and management

Key content Congenital anomalies affect more than 2% of fetuses in the UK, with 70% noncardiac in origin. Around 10% are gastrointestinal anomalies such as abdominal wall defects and intestinal atresias. Most gastrointestinal anomalies require postnatal surgical management. Obstetricians must understand the key features of diagnosis and management of common gastrointestinal anomalies. Clinically relevant and evidence‐based information helps facilitate parental reproductive autonomy through timely and informed counselling, planning for delivery and optimising perinatal outcomes. Management of pregnancies complicated by congenital gastrointestinal anomalies requires a multidisciplinary approach with specialist input. Learning objectives To be familiar with the antenatal diagnosis of gastrointestinal anomalies, associated conditions and potential obstetric complications To understand the antenatal and postnatal management of gastrointestinal anomalies including the approach to surgery To appreciate the role of multidisciplinary counselling in fetal medicine Ethical issues Antenatal counselling in the context of diagnostic and outcome uncertainties Consideration of termination of pregnancy for fetal anomaly, including grounds for, and timing of, decision‐making

Non-steroidal anti-inflammatory drug-induced perforation of Meckel’s diverticulum

Meckel’s diverticulum (MD) is commonest congenital gastrointestinal anomaly, the common complications associated with MD are hemorrhage, ulceration, intestinal obstruction, diverticulitis, umbilical anomalies, and neoplasm. Perforation of Meckel’s diverticulum is a rare entity and there’s very less documentation regarding the incidence of Meckel’s perforation. MD perforation is usually a life-threatening complication and is associated with high mortality, perforation is usually due to diverticulitis, peptic ulcer disease occurring in the ectopic gastric mucosa which might be present in MD. NSAID intake associated with Merkel’s perforation has been documented in a few studies. NSAID intake and gastric perforation have been well established but a relation between NSAIDs and heterotrophic gastric mucosa of MD has not been documented. With NSAIDs use becoming very common it is, therefore, important to document this association.

Efficacy of Early Enteral Nutrition on Gastrointestinal Surgery Outcomes: A Systematic Review and Meta-Analysis.

Congenital anomalies, congenital malformations, or birth defects can be defined as any structural or functional anomalies that develop prenatally and could be identified before, at birth, or later in life. Approximately 6% of babies are born with a congenital anomaly, which results in 2.4 million newborn deaths worldwide. This systematic review and meta-analysis ascertained the quantitative studies published in PubMed, ClinicalKey, Embase, CINAHL, Cochrane Library, and Google Scholar. Two authors independently screened and extracted the data from the primary studies that analyzed the efficacy of early enteral nutrition (EEN) on the postoperative outcome. This systematic review and meta-analysis adopted Cochrane Collaboration guidelines and reported using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. The methodological quality of trials was assessed by Cochrane Collaboration's risk of bias tool. Six trials, representing 488 children, with age ranging from 10 days to 6.5 years, fulfilled the inclusion criteria. EEN has significantly shortened hospital stay, induced early fecal movement, and reduced postoperative wound infections in children with congenital gastrointestinal abnormalities undergoing gastrointestinal anastomosis compared with children who received late enteral nutrition. The review also found that the experimental group who received EEN had no significant impact on the anastomosis leakage, vomiting, and abdominal distension. EEN has some positive effects on postsurgery outcomes among children with congenital gastrointestinal anomalies undergoing gastrointestinal anastomosis.

The Prevalence and Risk Factor of Congenital Heart Defects in Bangladesh

Background: Congenital heart disease is defined as a gross structural abnormalities of the heart or intra-thoracic great vessels that is either functionally significant or has the potential to be so. Objective: In this study main goal is to evaluate the prevalence and risk factor of congenital heart defects in Bangladesh. Method: This cross sectional study was carried out tertiary medical hospital from January 2021 to January 2022. A total of 100 children up to 12 years of age admitted in three pediatric units of this hospital during the study period. All normal patients were discharged and congenital heart disease cases had given follow up at 01months to 06 months interval. Results: During the study, majority were belong to 7-12 years age group, 54% and 60% were female. 20% had prematurity, followed by 10% had genetic syndrome, 3% had congenital neurological anomaly, 2% had congenital gastrointestinal anomaly. Majority had low birth weight, 40%. Followed by 35% cases mother had <37 week of gestational age, 62% cases had prenatal infection, 45% cases were Prenatal contact with toxic substances, 55% cases had gestational hypertension and diabetes, 40% cases prenatal anemia. In addition, 25% had Atrial septal defect, 22% had Ventricular septal defect, 20% had Patent foramen ovale, 11% had Patent ductus arteriosus, 10% had Pulmonary stenosis, 4% had Tetralogy of Fallot. Conclusion: In conclusion we can say prevalence of CHD is increasing where both a trial septal defect and Ventricular septal defect are quite common. In addition, lower birth weight, gestational hypertension and diabetes are reported as risk factor developing CHD in neonates.

Haploinsufficiencies of FOXF1, FOXC2 and FOXL1 genes originated from deleted 16q24.1q24.2 fragment related with alveolar capillary dysplasia with misalignment of pulmonary veins and lymphedema-distichiasis syndrome: relationship to phenotype

ObjectiveWe describe a fetus with a 2.12-Mb terminal deleted fragment in 16q associated with alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) and lymphedema-distichiasis syndrome (LDS) and intend to provide a comprehensive prenatal management strategy for the fetuses with ACDMPV and LDS through reviewing other similar published studies.MethodsThe fetus presented a series of diverse structural malformations including congenital cardiovascular, genitourinary and gastro-intestinal anomalies in ultrasound at 23 + 5 weeks of gestation (GA). Amniocentesis was conducted for karyotype analysis and copy number variation sequencing (CNV-seq) after informed consent.ResultsThe fetal karyotype was 46,XX, however the result of CNV-seq showed an approximately 2.12-Mb deletion in 16q24.1q24.2 (85220000-87340000) × 1 indicating pathogenicity.ConclusionGenomic testing should be recommend as a first line diagnostic tool for suspected ACDMPV and/or LDS or other genetic syndromes for the fetuses with structural abnormalities in clinical practice.

Coexisting gastrointestinal and hepatobiliary tract anomalies in omphalocele and gastroschisis: A twenty-year experience in a single tertiary medical center.

Omphalocele and gastroschisis are the two most common congenital abdominal wall defects; however, no previous study has focused on gastrointestinal and hepatobiliary tract malformations in these two conditions. This study aimed to investigate the demographic characteristics, coexisting congenital gastrointestinal and hepatobiliary tract anomalies, hospital course, and outcomes of patients with gastroschisis and omphalocele. This is retrospective chart review of all patients admitted to one tertiary medical center in Taiwan between January 1, 2000 and June 30, 2020 with a diagnosis of gastroschisis or omphalocele. The medical records were reviewed to obtain demographic data regarding coexisting gastrointestinal and hepatobiliary tract anomalies and outcomes. Of the 51 patients included, 21 had gastroschisis and 30 had omphalocele. Gastroschisis was associated with a significantly younger maternal age and a higher incidence of small for gestational age. Of the 30 patients with omphalocele, twelve had associated gastrointestinal and hepatobiliary anomalies. Seven of the 21 patients with gastroschisis had gastrointestinal anomalies, and none had hepatobiliary anomalies. Among the omphalocele patients, three (10%) had documented malrotation, and one developed midgut volvulus. Among gastroschisis patients, four patients (19%) had malrotation, and two developed midgut volvulus. There were no statistically significant differences in postoperative complications or mortality rates between those with and without gastrointestinal/hepatobiliary tract anomalies. The diversity of coexisting gastrointestinal and hepatobiliary tract anomalies is higher in the omphalocele than in gastroschisis. In addition, we demonstrate that patients with gastroschisis or omphalocele have a higher rate of intestinal malrotation and midgut volvulus.

Pattern of Major Congenital Anomalies of the Gastrointestinal Tracts among Live Neonates at Al-Mukalla,Yemen

Background: Major Congenital anomalies of the gastrointestinal tract(GIT) is a life threating condidition usually diagnosed in the neonatal period.Objective: To evaluate the prevalence of major congenital anomalies among live births at Al-Mukalla,Yemen.Patients and Methods: A hospital-based, descriptive cross sectional study was conducted during 2 years period, from January 1st 2019 to December 31th 2020 and include live neonates aged ≤ 4 weeks who were admitted with major congenital gastrointestinal anomalies. Results: The study include 62 neonates with major congenital GIT anomalies.The most common was imperforate anus in 41.9% followed by esophageal atresia with or without TEF in 24.2%, then hirschprung’s disease in 19.4%. Males are more common (61.3%) than females (38.7%).The incidence is 7.7 per 10.000 newborn. Isolated major GIT anomalies occurs in 64.5%, while associated extra -GIT anomalies occurs in 35.5% , the most common was congenital heart diseases that occurs in 17.7% of cases .The majority neonates were term in 90.3%, with birth weight ≥ 2.5 kg in 88.7%. Most mothers were < 35 years in 67.7% ,with positive parental consanguinity occurs in 37% of cases. Conclusion: High incidence of major Malformation were observed. Keywords: Congenital, anomalies, Major, gastrointestinal tracts ,Neonates , Yemen.

Down Syndrome

Key Points Occurs in approximately 1 in 730 live births and incidence closely related to age of mother.Caused by chromosomal abnormality trisomy 21 with 3 copies of chromosome 21 or, less commonly, with translocation to another chromosome.Most individuals have intellectual disability (varying degrees) as well as characteristic physical features.Can be diagnosed prenatally or with chromosome analysis after birth.Requires close care and coordination in early infancy and throughout childhood and adulthood because of increased prevalence of numerous other health issues, such as congenital heart disease, gastrointestinal anomalies, thyroid disease, celiac disease, and sleep apnea.

Paediatric surgery for congenital anomalies: the next frontier for global health

Paediatric surgery has historically been neglected in global health efforts.1,2 Estimates suggest that 6% of children worldwide are born with a congenital anomaly and 94% of these children are born in low-income and middle-income countries (LMICs).3 Surgical intervention for these children is potentially life-saving. However, many are among the two-thirds of the world's children, or an estimated 1·7 billion children, who lack access to surgical care.4 In The Lancet, the Global PaedSurg Research Collaboration report that the mortality of patients with congenital gastrointestinal anomalies in low-income countries is seven times that of children in high-income countries.

Evolution of Resting Energy Expenditure, Respiratory Quotient, and Adiposity in Infants Recovering from Corrective Surgery of Major Congenital Gastrointestinal Tract Anomalies: A Cohort Study.

This cohort study describes the evolution of resting energy expenditure (REE), respiratory quotient (RQ), and adiposity in infants recovering from corrective surgery of major congenital gastrointestinal tract anomalies. Energy and macronutrient intakes were assessed. The REE and RQ were assessed by indirect calorimetry, and fat mass index (FMI) was assessed by air displacement plethysmography. Longitudinal variations over time are described. Explanatory models for REE, RQ, and adiposity were obtained by multiple linear regression analysis. Twenty-nine infants were included, 15 born preterm and 14 at term, with median gestational age of 35.3 and 38.1 weeks and birth weight of 2304 g and 2935 g, respectively. In preterm infants, median REE varied between 55.7 and 67.4 Kcal/kg/d and median RQ increased from 0.70 to 0.86–0.92. In term infants, median REE varied between 57.3 and 67.9 Kcal/kg/d and median RQ increased from 0.63 to 0.84–0.88. Weight gain velocity was slower in term than preterm infants. FMI, assessed in a subset of 15 infants, varied between a median of 1.7 and 1.8 kg/m2 at term age. This low adiposity may be related to poor energy balance, low fat intakes, and low RQ¸ that were frequently recorded in several follow-up periods.

Extrarenal Wilms tumor in children: A retrospective observational case series

Pediatric extrarenal Wilms tumor (ERWT) is rare. The diversity of clinical characteristics makes diagnosis, treatment and judging the prognosis difficult. Long-term follow-up outcomes and the possible prognostic factors of ERWT are still insufficient. To identify the characteristics, therapeutic strategies and long-term results of pediatric ERWT. All children with ERWT in our institution were retrospectively reviewed. The National Wilms Tumor Study (NWTS) system was used to evaluate tumor grade. Among the 876 patients with Wilms tumor in our institution between January 1986 and July 2018, 5 (0.57%) patients had ERWT. Of the 5 children with ERWT, the locations were the retroperitoneum in 3 patients (including 1 presacral) and the gubernaculum testis of an undescended testis and a duplicate sigmoid colon in 1 patient each. Two patients were stage II, and 3 patients were stage III. The three patients with larger tumor sizes had preoperative tumor rupture. In the long-term follow-up, ranging from 1.0 to 10.8 years, 3 patients had disease-free survival, and 2 patients with older age, a larger tumor size and preoperative tumor rupture had recurrence with metastasis, including 1 death. Wilms tumor extremely rarely originates outside the kidney. The current case series represents the first report of ERWT accompanied by a duplicate sigmoid colon. ERWT can coassociate with congenital gastrointestinal and genitourinary system anomalies, such as undescended testis and duplicate sigmoid colon, which provide clues to the preoperative diagnosis of ERWT. Deep and not easily palpated locations for the ERWT and older ages were associated with diagnosis delay, which can lead to enlargement of the tumor, an increased risk of preoperative tumor rupture and advancement of the tumor stage. Although only 3% of ERWT cases were metastatic according to previous reports, 2 of 5 patients (patients 1 and 4) with older age, larger tumor size and preoperative tumor rupture had recurrence and metastases in the current study. Thus, patients with poor prognoses often require aggressive combination treatments, and more attention is needed in terms of the recurrence, metastases and fatality of ERWT. ERWTs are rare tumors and can coassociate with congenital gastrointestinal and genitourinary system anomalies. The prognosis of ERWT is comparable to that of Wilms tumor located at normal anatomical sites.

Impact of Nutrition Support Team on Postoperative Nutritional Status and Outcome of Patients with Congenital Gastrointestinal Anomalies.

BACKGROUND The aim of this study was to evaluate postoperative nutritional status in patients who underwent operations due to congenital gastrointestinal anomalies in surgical neonatal intensive care units (NICUs) and to investigate the role of nutrition support teams (NSTs) on the outcome. METHODS A retrospective clinical study was carried out at two NICUs in Dr. Sheikh Pediatric Hospital, Mashhad, Iran. One of the NICUs was supported by NST and the other was not. A total of 120 patients were included through a non-random simple sampling. Different variables such as age, sex, prematurity, type of anomaly, birth weight, use of vasoactive drugs, weight gain in NICU, length of NICU stay, postoperative enteral nutrition initiation, duration of mechanical ventilation, mortality rate, maximum of blood sugar, the amount of calorie delivered to the calorie requirement ratio, and distribution of energy from enteral or parenteral roots were compared between the patients of two NICUs. RESULTS Median weight gain and the amount of calorie delivered during NICU stay in subjects of NSTsupported NICU was significantly more than other NICU. There was no significant difference in the length of NICU stay, enteral nutrition initiation after the operation, ventilation days, and percent of mortality between the two groups. The percentage of enteral feeding was also increased by about 2.8%, which was not significant. CONCLUSION NST could increase post-operative weight gain and calorie delivery in patients as well as providing an increase in enteral feeding rather than parenteral.

Genetic counseling for fetal gastrointestinal anomalies.

Congenital gastrointestinal anomalies are common findings with relatively established methods of treatment. However, the genetic cause of how these defects occur and how that may impact a child's lifelong care is less established. Genetic testing has improved significantly in recent years, yet reviews documenting prenatal genetic counseling and testing guidelines have not been comprehensively updated. Congenital anomalies of the foregut, such as tracheoesophageal fistula carry a high association with genetic disorders, both in isolation and syndromic forms. Duodenal atresia remains highly associated with Trisomy 21 but is not enriched in other genetic conditions. Disorders of the midgut, such as omphalocele often have a genetic cause and may require both cytogenetic and panel testing to obtain a diagnosis. The etiologic basis of hindgut malformations remain largely unknown, though imperforate anus as well as Hirschprung's disease have been associated with many micro deletion syndromes as well as in association with other birth defects as part of larger syndromes. Prenatal diagnostic genetic testing through amniocentesis or chorionic villus sampling can be offered to every patient who wants to learn genetic information about their fetus. Cytogenetic testing, such as microarray is a first tier test to assess cause for these conditions and can provide meaningful answers. When a gastrointestinal anomaly is identified in association with an additionally affected organ system next-generation sequencing and defect-specific genetic testing panels can be necessary to understand cause as well as prognosis to best prepare families for the medical management that lies ahead.

Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders.

This study aimed to investigate growth among neonates with gastrointestinal disorders. Inclusion criteria included neonates with gastroschisis, omphalocele, intestinal atresia, tracheoesophageal fistula, Hirschsprung's disease, malabsorption disorders, congenital diaphragmatic hernia, and imperforate anus born between 2010 and 2018. Anthropometrics were collected for the first 30 months, and a subgroup analysis was performed for gastroschisis infants. In 61 subjects, 13% developed severe growth failure within the first month. One-, four-, and nine-month weight and length z-scores were less than birth weight in all infants (p < 0.05). In infants with gastroschisis, a similar pattern was observed for weight z-scores only (p < 0.05). From birth to 15 months, head circumference z-score increased over time in all infants (p = 0.001), while in gastroschisis infants, weight, length, and head circumference z-scores increased over time (p < 0.05). In a cohort of infants with gastrointestinal disorders, growth failure was followed by catch-up growth.

Antenatal predictors of intestinal pathologies in fetal bowel dilatation.

Fetal bowel dilatation (FBD) in the late trimester of pregnancy can be related with varies of prognosis. Our aims were to obtain antenatal factors that might have relevance for the distinct prognosis with FBD. Seven features of 68 pregnancies presented with FBD were assessed. The best cut-off value to predict intestinal outcomes was selected using receiver-operating characteristics curves, and the effective variables were included into a logistic regression model. The best cut-off valves to predict intestinal pathologies were 14.5 mm of fetus dilated loop and 37.7 weeks of gestational age at delivery, respectively. The congenital gastrointestinal tract anomalies included 24 cases (92.3%) of intestine atresia, 1 case (3.85%) of small intestine volvulus and 1 case (3.85%) of midgut malrotation. Fetal dilated loops and gestational age at delivery are both an independent risk factor for predicting intestinal pathologies of newborns, which should arouse high attention.