Department of Pediatric Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Prenat Diagn. 2010 Mar;30(3):274-9. doi: 10.1002/pd.2466.
Clinical symptoms and ultrasound signs during pregnancy could suggest the presence of esophageal atresia (EA). However, most often EA is diagnosed postnatally. The aim of our study is to evaluate the course and outcome for prenatally and postnatally diagnosed EA. In addition, we studied the outcome of isolated versus nonisolated EA.
In a retrospective data analysis, ultrasound characteristics, maternal and neonatal variables as well as clinical outcome were compared for fetuses/neonates with prenatal (n = 30) or postnatal (n = 49) diagnosis of EA. Clinical outcome in terms of morbidity and mortality of isolated EA was compared with that of EA complicated by chromosomal or structural anomalies.
Prenatally diagnosed children were born 2 weeks earlier than postnatally diagnosed children (36.4 weeks vs 38.2 weeks; P = 0.02). The former had higher mortality rates (30 vs 12%; P = 0.05) and more associated anomalies (80 vs 59%; P = 0.04). In both subsets, there was a high morbidity rate in the survivors (not significant). Nonisolated EA was associated with greater occurrence of polyhydramnios (53 vs 27%; P = 0.04) and higher mortality rate (28 vs 0%; P = 0.002).
Mortality was significantly higher in prenatally diagnosed infants and in infants with additional congenital anomalies. Isolated EA is associated with good outcome.
孕妇在妊娠期间的临床症状和超声征象可能提示食管闭锁（EA）的存在。然而，EA 通常在产后诊断。我们研究的目的是评估产前和产后诊断的 EA 的病程和结果。此外，我们研究了孤立性与非孤立性 EA 的结果。
在回顾性数据分析中，比较了产前（n=30）或产后（n=49）诊断为 EA 的胎儿/新生儿的超声特征、母婴变量以及临床结果。孤立性 EA 的发病率和死亡率的临床结果与伴有染色体或结构异常的 EA 进行了比较。
产前诊断的儿童比产后诊断的儿童早出生 2 周（36.4 周比 38.2 周；P=0.02）。前者死亡率更高（30%比 12%；P=0.05），伴发畸形更多（80%比 59%；P=0.04）。在这两个亚组中，幸存者的发病率都很高（无显著差异）。非孤立性 EA 与羊水过多的发生率更高（53%比 27%；P=0.04）和死亡率更高（28%比 0%；P=0.002）有关。
产前诊断的婴儿和伴有其他先天性异常的婴儿死亡率明显更高。孤立性 EA 与良好的结果相关。
