Kim Ji Ye, You Ji Yeon, Chang Kylie Hae-Jin, Choi Suk-Joo, Oh Soo-Young, Seo Jeong-Meen, Roh Cheong-Rae, Kim Jong-Hwa
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul Korea.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul Korea
J Ultrasound Med. 2016 Sep;35(9):1931-8. doi: 10.7863/ultra.15.09074. Epub 2016 Jul 27.
The purpose of this study was to evaluate the association of prenatal sonographic findings with adverse outcomes and the causes of duodenal obstruction.
A total of 59 cases of congenital duodenal obstruction were included in this study. The sonographic findings, including the degree of duodenal dilatation, polyhydramnios, and their change over gestation, were investigated. Adverse outcomes were defined as fetal death in utero, postnatal death, and gastrointestinal complications requiring readmission or reoperation during the follow-up period. The cause of duodenal obstruction was also assessed.
Among the patients studied, 2 (3.4%) had fetal death in utero and 2 (3.5%) had postnatal death. Gastrointestinal complications requiring readmission or reoperation occurred in 10.9%. In the cases with or without adverse outcomes, no significant differences were observed in the prenatal sonographic findings: maximum duodenal dilatation, mean amniotic fluid index, and the changes in these parameters with advancing gestation. The cases with adverse outcomes were associated with a younger gestational age at delivery compared to the cases without adverse outcomes. Notably, the degree of duodenal dilatation and amniotic fluid volume were greater in duodenal atresia than in other causes of obstruction, including duodenal stenosis, a duodenal web, and an annular pancreas. In the study population, the overall postoperative survival rate was 98.2%.
Prenatal sonographic findings of duodenal obstruction were not associated with adverse outcomes; however, they may be helpful for differentiating the cause of duodenal obstruction.
本研究旨在评估产前超声检查结果与不良结局的相关性以及十二指肠梗阻的病因。
本研究共纳入59例先天性十二指肠梗阻病例。调查超声检查结果，包括十二指肠扩张程度、羊水过多及其在孕期的变化。不良结局定义为宫内胎儿死亡、出生后死亡以及随访期间需要再次入院或再次手术的胃肠道并发症。同时评估十二指肠梗阻的病因。
在研究的患者中，2例（3.4%）发生宫内胎儿死亡，2例（3.5%）发生出生后死亡。需要再次入院或再次手术的胃肠道并发症发生率为10.9%。在有或无不良结局的病例中，产前超声检查结果（十二指肠最大扩张程度、平均羊水指数以及这些参数随孕周增加的变化）未观察到显著差异。与无不良结局的病例相比，有不良结局的病例分娩时孕周较小。值得注意的是，十二指肠闭锁时十二指肠扩张程度和羊水量大于其他梗阻原因，包括十二指肠狭窄、十二指肠蹼和环状胰腺。在研究人群中，总体术后生存率为98.2%。
产前超声检查发现的十二指肠梗阻与不良结局无关；然而，它们可能有助于鉴别十二指肠梗阻的病因。
