Janoo Jabin, Cunningham Micheal, Hobbs Gerald R, O'Bringer Angela, Merzouk Maria
Department of Obstetrics and Gynecology, West Virginia University, P.O. Box 9186, Morgantown, WV 26505, USA.
W V Med J. 2013 Mar-Apr;109(2):22-7.
Gastrochisis is a congenital condition resulting in significant morbidity and mortality. Multiple studies have been done to evaluate the value of prognostic indicators with conflicting results. The aim of this study was to evaluate the role of ultrasound in this condition at a single institution while limiting the provider variables that may affect neonatal outcome.
The antepartum charts of expectant mothers of affected fetuses as well as the neonatal hospital charts were reviewed at length. The cases were identified over a period of 4 years from April 1998 to February 2002. In addition, the archived photographs of ultrasounds performed on these fetuses were also reviewed and reread by two independent providers who were blinded to the outcome. Adverse neonatal outcome, including death and time to feeding (amongst many other variables) were assessed against the different ultrasound parameters including bowel thickness and dilation.
25 patients were identified in the stated time frame. Six cases had to be dropped from the final analysis due to incomplete data including the transfer of 3 babies. There were 4 neonatal deaths. The mean birth weight was 2384 grams. There was a significant association with dilation and delta dilation (defined as the difference in bowel dilation from the final ultrasound from the baseline ultrasound cutoff of 4 mm) and time to feeding, time on ventilator and hospital stay. (P< 0.005). Other ultrasound parameters were not significantly correlated with neonatal outcome.
Most ultrasound parameters do not help prognosticate the neonatal outcome in babies affected with this condition except for dilation and delta dilation, which are strong predictors of morbidity in the post delivery period. This information may be helpful to providers and parents of affected fetuses.
腹裂是一种导致严重发病和死亡的先天性疾病。已经进行了多项研究来评估预后指标的价值，但结果相互矛盾。本研究的目的是在单一机构评估超声在这种疾病中的作用，同时限制可能影响新生儿结局的提供者变量。
详细回顾了受影响胎儿的准妈妈的产前图表以及新生儿医院图表。在1998年4月至2002年2月的4年期间确定了这些病例。此外，还对这些胎儿进行的超声存档照片进行了回顾，并由两名对结局不知情的独立提供者重新阅读。针对不同的超声参数，包括肠壁厚度和扩张情况，评估不良新生儿结局，包括死亡和喂养时间（以及许多其他变量）。
在规定的时间范围内确定了25例患者。由于数据不完整，包括3名婴儿的转院，6例不得不从最终分析中剔除。有4例新生儿死亡。平均出生体重为2384克。扩张和增量扩张（定义为从最终超声到基线超声4毫米的肠扩张差异）与喂养时间、呼吸机使用时间和住院时间之间存在显著关联（P<0.005）。其他超声参数与新生儿结局无显著相关性。
除了扩张和增量扩张外，大多数超声参数无助于预测患有这种疾病的婴儿的新生儿结局，而扩张和增量扩张是产后发病的有力预测指标。这些信息可能对受影响胎儿的提供者和父母有所帮助。
