Variables reviewed
Prenatal ultrasound reports and images from the 55 participants were reviewed for several variables :
Ultrasound characteristics
• Intra-abdominal intestinal diameter ( IAID )
• Extra-abdominal intestinal diameter ( EAID )
• Echogenicity
• Amniotic fluid index
• Abdominal circumference ( AC )
• Thickness of bowel wall
• Visceral content in herniation
• Defect size
Patient outcomes
• Complex vs . simple gastroschisis
• Enteral feeding
• Length of NICU stay
• 30-day readmission
• Infection complications
Cohort characteristics
21 years old Mothers ’ median age
2.3 kg Neonate median weight
36 weeks Median gestational age at delivery
43 days Median length of stay
31 days Median time to enteral feeding
29 % Complex gastroschisis ( N = 16 )
Key findings
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Compared to simple gastroschisis , complex gastroschisis had higher :
• IAID • Fetal AC • Amniotic fluid index
• Bowel wall thickening No other differences were significant between the two groups .
IAID was the only ultrasound finding with a strong enough relationship with patient outcomes to be determined predictive .
Larger IAIDs were associated with :
• 20 % increased chance of complex diagnosis
• Longer time to full enteral feeding ( intake and processing of nutrients through the gastrointestinal tract )
And most importantly : 4
A 17 mm IAID at 32 weeks gestational age reliably distinguishes between complex and simple cases
Complex cases
IAID of >= 17 mm correctly identified 75 % ( sensitivity )
75 % chance with an IAID > 17 mm ( PPV )
Conclusions
Based on the study ’ s findings , IAID is associated with a longer time to full enteral feeding and the diagnosis of complex gastroschisis .
The study titled “ Examination of Prenatal Sonographic Findings : Intra-Abdominal Bowel Dilation Predicts Poor Gastroschisis Outcomes ” was published in the August 2019 issue of Fetal Diagnosis and Therapy .
Simple cases
IAID of < 17 mm correctly identified 92 % ( sensitivity )
-92 % chance when an IAID < 17 mm ( NPV )
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