Frybova Barbora, Vlk Radovan, Kokesova Alena, Rygl Michal
Department of Paediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Úvalu 84, 15006, Prague 5, Czech Republic,
Pediatr Surg Int. 2015 Apr;31(4):381-7. doi: 10.1007/s00383-015-3675-2. Epub 2015 Feb 20.
The aim of the study was to identify which prenatal ultrasonographic findings in fetuses with gastroschisis correlate with complicated postnatal outcome.
Ultrasound findings at the 30th week of pregnancy and medical reports were statistically analyzed to identify independent prenatal ultrasonographic predictors of postnatal outcome.
Completed prenatal data were gathered from 64 pregnancies. Prenatal intra-abdominal bowel dilatation (cutoff 10 mm) correlated with the presence of atresia (p < 0.01), longer administration of parenteral nutrition, extended hospital stay (median 53 vs. 21 days; 68 vs. 36 days, both p < 0.05), and greater number of additional surgical procedures (p < 0.05). Infants with antenatal presence of thickened bowel wall (greater than or equal to 3 mm) required longer administration of parenteral nutrition (median 34 vs. 20 days; p < 0.01) and prolonged stay (median 44 vs. 37 days; p < 0.05). Presence of oligohydramnion (amniotic fluid index below 8 cm) was connected with longer administration of parenteral nutrition in newborns (median 30 vs. 16 days; p < 0.05).
The isolated presence of oligohydramnion with amniotic fluid index below 8 cm, thickened bowel wall equal to or more than 3 mm and the prenatal intra-abdominal dilatation with 10 mm cutoff had significant predictive value for the adverse postnatal outcome of patients with gastroschisis.
本研究的目的是确定腹裂胎儿的哪些产前超声检查结果与产后复杂结局相关。
对妊娠30周时的超声检查结果和医学报告进行统计分析,以确定产后结局的独立产前超声预测指标。
收集了64例妊娠的完整产前数据。产前腹腔内肠管扩张(截断值10 mm)与闭锁的存在相关(p < 0.01),肠外营养使用时间更长,住院时间延长(中位数53天对21天;68天对36天,均p < 0.05),以及额外手术操作的次数更多(p < 0.05)。产前肠壁增厚(大于或等于3 mm)的婴儿需要更长时间的肠外营养(中位数34天对20天;p < 0.01)和更长的住院时间(中位数44天对37天;p < 0.05)。羊水过少(羊水指数低于8 cm)与新生儿肠外营养使用时间更长相关(中位数30天对16天;p < 0.05)。
羊水指数低于8 cm的单纯羊水过少、肠壁增厚等于或大于3 mm以及截断值为10 mm的产前腹腔内扩张对腹裂患者的不良产后结局具有显著预测价值。