Iacobelli Barbara D, Zaccara Antonio, Spirydakis Ioannis, Giorlandino Claudio, Capolupo Irma, Nahom Antonella, Bagolan Pietro
Newborn Surgery Unit, Bambino Gesù Children's Hospital, Rome, Italy.
Prenat Diagn. 2006 Mar;26(3):214-7. doi: 10.1002/pd.1381.
To evaluate polyhydramnios as a sign of extreme disproportion of atretic segments in small bowel atresia (SBA).
Twenty-eight patients with a prenatal diagnosis (PD) of SBA undergoing neonatal surgical treatment were reviewed retrospectively. Parameters recorded were gestational age, birth weight, surgical procedure, rate of complications, parenteral nutrition (PN) days and length of stay (LOS). Patients were divided into two groups: Group A with delayed anastomosis and Group B with direct anastomosis.
Seventeen subjects were in Group A while 11 were in Group B. The two groups did not differ with regard to gestational age at diagnosis, birth weight and obstetrical management. Polyhydramnios was present in both Group A (64.7%) and Group B (9%) (p < 0.05). Patients in Group A needed a longer period on PN, had a longer LOS and exhibited significantly higher rates of complication.
In the absence of other malformations, association of dilated bowel loops and polyhydramnios is highly predictive of severe SBA, which can in no instance be amenable to one-stage reconstruction. Because of its consequences on postnatal treatment, such information should be conveyed to the prospective parents at the time of counselling.
评估羊水过多作为小肠闭锁（SBA）中闭锁段极度不称的一个征象。
回顾性分析28例产前诊断为SBA并接受新生儿外科治疗的患者。记录的参数包括胎龄、出生体重、手术方式、并发症发生率、肠外营养（PN）天数和住院时间（LOS）。患者分为两组：A组为延迟吻合组，B组为直接吻合组。
A组17例，B组11例。两组在诊断时的胎龄、出生体重和产科处理方面无差异。A组（64.7%）和B组（9%）均存在羊水过多（p<0.05）。A组患者需要更长时间的PN支持，住院时间更长，并发症发生率显著更高。
在无其他畸形的情况下，扩张的肠袢与羊水过多相关高度提示严重SBA，绝不可能一期重建。鉴于其对出生后治疗的影响，此类信息应在咨询时告知准父母。
