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胎儿先天性腹壁裂时存在产前腹腔内肠管扩张与出生后胃肠道并发症相关。

Prenatal intraabdominal bowel dilation is associated with postnatal gastrointestinal complications in fetuses with gastroschisis.

机构信息

Department of Radiology, University of California at San Francisco School of Medicine, San Francisco, CA 94143, USA.

出版信息

Am J Obstet Gynecol. 2010 Apr;202(4):396.e1-6. doi: 10.1016/j.ajog.2009.10.888. Epub 2009 Dec 30.

Abstract

OBJECTIVE

The purpose of this study was to determine whether prenatal intraabdominal bowel dilation (IBD) is associated with increased postnatal complications in fetuses with gastroschisis.

STUDY DESIGN

A retrospective review was performed on all maternal-fetus pairs with prenatally diagnosed gastroschisis that was treated at the University of California San Francisco from 2002-2008. Postnatal outcomes were compared between fetuses with and without IBD.

RESULTS

Forty-three of 61 maternal-fetal pairs met the criteria for inclusion. Sixteen fetuses (37%) had evidence of IBD. Fetuses with IBD were significantly more likely to have postnatal bowel complications (38% vs 7%; P = .037). The presence of multiple loops of IBD (n = 6) as opposed to a single loop (n = 10) was associated highly with bowel complications and increased time to full enteral feeding and length of hospital stay (100% vs 0% [P = .001]; 44 vs 23 days [P = .034]; 69 vs 27 days [P = .001], respectively).

CONCLUSION

IBD is associated with increased postnatal complications in infants with prenatally diagnosed gastroschisis; however, this association seems to be limited to those with multiple loops of dilated intraabdominal bowel.

摘要

目的

本研究旨在确定胎儿先天性腹壁膨出(IBD)是否与先天性腹壁膨出胎儿的出生后并发症增加有关。

研究设计

对 2002 年至 2008 年期间在加利福尼亚大学旧金山分校接受治疗的所有经产前诊断为先天性腹壁膨出的母婴对进行了回顾性研究。比较了有和没有 IBD 的胎儿的出生后结局。

结果

61 对母婴对中符合纳入标准的有 43 对。16 例胎儿(37%)有 IBD 证据。有 IBD 的胎儿更有可能出现出生后肠并发症(38% vs 7%;P =.037)。多个肠环 IBD(n = 6)的存在与肠并发症和全肠喂养时间延长以及住院时间延长高度相关,而不是单个肠环 IBD(n = 10)(100% vs 0%[P =.001];44 天 vs 23 天[P =.034];69 天 vs 27 天[P =.001])。

结论

IBD 与经产前诊断的先天性腹壁膨出婴儿的出生后并发症增加有关;然而,这种关联似乎仅限于那些有多段扩张的腹腔肠环的婴儿。

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