Prenatal diagnosis and outcome of fetal gastrointestinal obstruction

Patricio E. Lau, Stephanie Cruz, Christopher I. Cassady, Amy R. Mehollin-Ray, Rodrigo Ruano, Sundeep Keswani, Timothy C. Lee, Oluyinka O. Olutoye, Darrell L. Cass

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction The purpose of this study was to evaluate the accuracy of prenatal diagnosis for fetuses with gastrointestinal (GI) obstruction with correlation to postnatal outcomes. Methods Fetuses diagnosed with GI obstruction (excluding esophageal and duodenal) were reviewed for those evaluated between 2006 and 2016. Prenatal diagnosis and imaging studies were compared to postnatal findings. Outcomes evaluated included diagnostic accuracy, rate of other anomalies, neonatal length of stay, incidence of short bowel syndrome, and discharge with TPN or gastrostomy. Results Forty-eight patients were diagnosed prenatally with obstruction. Six patients were excluded owing to incomplete records and follow-up. Twelve fetuses were diagnosed with ultrasound alone, and thirty-four with ultrasound and MRI. A diagnosis of obstruction was accurate in 88.1% (n = 37/42) with a positive predictive value of 91.3%, while US with MRI had an accuracy of 84.4%. Associated anomalies were highest among fetuses with anorectal obstruction (90.1%), compared to large (50%) or small bowel obstruction (28%). Survival rate was lowest for anorectal obstruction (54.5%), compared to large or small bowel obstruction (100% for both). Conclusion Fetal MRI is an accurate modality in the diagnosis of fetal GI obstruction and can complement findings characterized by ultrasound. Fetuses with anorectal obstruction have a higher rate of associated anomalies and the lowest survival. Level of evidence IIb.

Original languageEnglish (US)
Pages (from-to)722-725
Number of pages4
JournalJournal of Pediatric Surgery
Volume52
Issue number5
DOIs
StatePublished - May 1 2017
Externally publishedYes

Fingerprint

Prenatal Diagnosis
Fetus
Short Bowel Syndrome
Gastrostomy
Length of Stay
Survival Rate
Survival
Incidence

Keywords

  • Congenital bowel obstruction
  • Fetal MRI, fetal imperforate anus
  • Gastrointestinal abnormalities
  • Prenatal diagnosis

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Lau, P. E., Cruz, S., Cassady, C. I., Mehollin-Ray, A. R., Ruano, R., Keswani, S., ... Cass, D. L. (2017). Prenatal diagnosis and outcome of fetal gastrointestinal obstruction. Journal of Pediatric Surgery, 52(5), 722-725. https://doi.org/10.1016/j.jpedsurg.2017.01.028

Prenatal diagnosis and outcome of fetal gastrointestinal obstruction. / Lau, Patricio E.; Cruz, Stephanie; Cassady, Christopher I.; Mehollin-Ray, Amy R.; Ruano, Rodrigo; Keswani, Sundeep; Lee, Timothy C.; Olutoye, Oluyinka O.; Cass, Darrell L.

In: Journal of Pediatric Surgery, Vol. 52, No. 5, 01.05.2017, p. 722-725.

Research output: Contribution to journalArticle

Lau, PE, Cruz, S, Cassady, CI, Mehollin-Ray, AR, Ruano, R, Keswani, S, Lee, TC, Olutoye, OO & Cass, DL 2017, 'Prenatal diagnosis and outcome of fetal gastrointestinal obstruction', Journal of Pediatric Surgery, vol. 52, no. 5, pp. 722-725. https://doi.org/10.1016/j.jpedsurg.2017.01.028
Lau, Patricio E. ; Cruz, Stephanie ; Cassady, Christopher I. ; Mehollin-Ray, Amy R. ; Ruano, Rodrigo ; Keswani, Sundeep ; Lee, Timothy C. ; Olutoye, Oluyinka O. ; Cass, Darrell L. / Prenatal diagnosis and outcome of fetal gastrointestinal obstruction. In: Journal of Pediatric Surgery. 2017 ; Vol. 52, No. 5. pp. 722-725.
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AB - Introduction The purpose of this study was to evaluate the accuracy of prenatal diagnosis for fetuses with gastrointestinal (GI) obstruction with correlation to postnatal outcomes. Methods Fetuses diagnosed with GI obstruction (excluding esophageal and duodenal) were reviewed for those evaluated between 2006 and 2016. Prenatal diagnosis and imaging studies were compared to postnatal findings. Outcomes evaluated included diagnostic accuracy, rate of other anomalies, neonatal length of stay, incidence of short bowel syndrome, and discharge with TPN or gastrostomy. Results Forty-eight patients were diagnosed prenatally with obstruction. Six patients were excluded owing to incomplete records and follow-up. Twelve fetuses were diagnosed with ultrasound alone, and thirty-four with ultrasound and MRI. A diagnosis of obstruction was accurate in 88.1% (n = 37/42) with a positive predictive value of 91.3%, while US with MRI had an accuracy of 84.4%. Associated anomalies were highest among fetuses with anorectal obstruction (90.1%), compared to large (50%) or small bowel obstruction (28%). Survival rate was lowest for anorectal obstruction (54.5%), compared to large or small bowel obstruction (100% for both). Conclusion Fetal MRI is an accurate modality in the diagnosis of fetal GI obstruction and can complement findings characterized by ultrasound. Fetuses with anorectal obstruction have a higher rate of associated anomalies and the lowest survival. Level of evidence IIb.

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