Department of Surgery, University of Colorado, Aurora, Colorado, USA.
Colorado Fetal Care Center, University of Colorado School of Medicine, Aurora, Colorado, USA.
Fetal Diagn Ther. 2020;47(3):245-250. doi: 10.1159/000501592. Epub 2019 Aug 27.
Gastroschisis is an anterior abdominal wall defect with variable outcomes. There are conflicting data regarding the prognostic value of sonographic findings.
The aim of this study was to identify prenatal ultrasonographic features associated with poor neonatal outcomes.
A retrospective review of 55 patients with gastroschisis from 2007 to 2017 was completed. Ultrasounds were reviewed for extra-abdominal intestinal diameter (EAID) and intra-abdominal intestinal diameter (IAID), echogenicity, visceral content within the herniation, amniotic fluid index, defect size, and abdominal circumference (AC). Ultrasound variables were correlated with full enteral feeding and the diagnosis of a complex gastroschisis.
Bivariate analysis demonstrated an increased time to full enteral feeds with increasing number of surgeries, EAID, and IAID. Additionally, there was a significant relationship between IAID and AC percentile with the diagnosis of complex gastroschisis. On multivariate analysis, only IAID was significant and increasing diameter had a 2.82 (95% CI 1.02-7.78) higher odds of a longer time to full enteral feeds and a 1.2 (95% CI 1.05-1.36) greater odds of the diagnosis of a complex gastroschisis.
Based on these findings, IAID is associated with a longer time to full enteral feeding and the diagnosis of complex gastroschisis.
腹裂是一种前腹壁缺陷，其结局存在差异。关于超声检查结果的预后价值存在矛盾的数据。
本研究旨在确定与新生儿不良结局相关的产前超声特征。
回顾性分析了 2007 年至 2017 年期间 55 例腹裂患儿的资料。对超声检查的额外腹腔肠径（EAID）和腹腔肠径（IAID）、回声、疝内内脏内容物、羊水指数、缺陷大小和腹围（AC）进行了评估。超声变量与完全肠内喂养和复杂腹裂的诊断相关。
在单变量分析中，手术次数、EAID 和 IAID 的增加与完全肠内喂养的时间延长相关。此外，IAID 与 AC 百分位数与复杂腹裂的诊断之间存在显著关系。多变量分析显示，只有 IAID 有统计学意义，直径的增加使完全肠内喂养的时间延长的几率增加 2.82（95%CI 1.02-7.78），复杂腹裂的诊断几率增加 1.2（95%CI 1.05-1.36）。
根据这些发现，IAID 与完全肠内喂养时间延长和复杂腹裂的诊断相关。
