Fetal intra-abdominal bowel dilation in prediction of complex gastroschisis

Carregando...
Imagem de Miniatura
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
Citação
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, v.54, n.3, p.376-380, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective To investigate intra-abdominal bowel dilation (IABD) in the prediction of complex gastroschisis. Methods This was a retrospective study of 174 singleton pregnancies with isolated fetal gastroschisis, resulting in live birth and with available ultrasound images from visits at both 20-22 and 30-32 weeks' gestation. IABD was measured as the greatest transverse diameter of the most dilated intra-abdominal bowel segment, by an operator blinded to postnatal outcome. The distribution of IABD measurements in those with complex and those with simple gastroschisis was determined and the best cut-off value to predict complex gastroschisis was selected using receiver-operating characteristics (ROC) curves. The area under the ROC curve (AUC), detection rate (DR), false-positive rate (FPR), positive predictive value (PPV) and negative predictive value (NPV) were determined. Results The study population included 39 (22.4%) cases of complex and 135 (77.6%) cases of simple gastroschisis. In the prediction of complex gastroschisis, the AUC at 20-22 weeks' gestation was 0.742 (95% CI, 0.628-0.856) and the respective value for 30-32 weeks was 0.820 (95% CI, 0.729-0.910). At the IABD cut-off of 7 mm at 20-22 weeks, DR, FPR, PPV and NPV for complex gastroschisis were 61.5%, 6.7%, 72.7% and 89.4%, respectively, and at IABD cut-off of 14 mm at 30-32 weeks, the respective values were 64.9%, 5.9%, 75.0% and 90.7%. Conclusion Measurement of IABD at 20-22 or at 30-32 weeks' gestation is useful in the prediction of complex gastroschisis.
Palavras-chave
bowel atresia, bowel dilatation, bowel necrosis, bowel perforation, bowel stenosis, fetal gastroschisis
Referências
  1. Andrade WS, 2018, FETAL DIAGN THER, V43, P45, DOI 10.1159/000464245
  2. Castilla EE, 2008, AM J MED GENET C, V148C, P162, DOI 10.1002/ajmg.c.30181
  3. Contro E, 2010, ULTRASOUND OBST GYN, V35, P702, DOI 10.1002/uog.7514
  4. D'Antonio F, 2015, PEDIATRICS, V136, pE159, DOI 10.1542/peds.2015-0017
  5. Emil S, 2018, SEMIN PEDIATR SURG, V27, P309, DOI 10.1053/j.sempedsurg.2018.08.003
  6. Geslin D, 2017, PRENATAL DIAG, V37, P168, DOI 10.1002/pd.4984
  7. Ghionzoli M, 2012, J PEDIATR SURG, V47, P322, DOI 10.1016/j.jpedsurg.2011.11.022
  8. Goetzinger KR, 2014, ULTRASOUND OBST GYN, V43, P420, DOI 10.1002/uog.12568
  9. Kuleva M, 2012, BJOG-INT J OBSTET GY, V119, P102, DOI 10.1111/j.1471-0528.2011.03183.x
  10. Lap CCMM, 2016, EARLY HUM DEV, V103, P209, DOI 10.1016/j.earlhumdev.2016.10.002
  11. Martillotti G, 2016, FETAL DIAGN THER, V39, P279, DOI 10.1159/000440699
  12. Molik KA, 2001, J PEDIATR SURG, V36, P51, DOI 10.1053/jpsu.2001.20004
  13. Nicolaides KH, 2018, ULTRASOUND OBST GYN, V52, P44, DOI 10.1002/uog.19073
  14. Osmundo GD, 2019, ACTA OBSTET GYN SCAN, V98, P154, DOI 10.1111/aogs.13473
  15. ROBINSON HP, 1975, BRIT J OBSTET GYNAEC, V82, P702, DOI 10.1111/j.1471-0528.1975.tb00710.x
  16. SNIJDERS RJM, 1994, ULTRASOUND OBST GYN, V4, P34, DOI 10.1046/j.1469-0705.1994.04010034.x