Gastrosquise fetal isolada: relação entre dilatação intestinal e resultados perinatais adversos / Isolated fetal gastroschisis: relation between bowel dilation and adverse perinatal outcome

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

30/11/2011

RESUMO

Objectives: Evaluate bowel diameter as a predictor of adverse outcome in isolated fetal gastroschisis. Methods: Retrospective study involving 94 singleton pregnancies. Ultrasound measurements of herniated bowel transverse diameter (BTD) were performed up to 3 weeks before delivery. Adverse outcome was intrauterine/ neonatal death and/or bowel complications. Results: Last BTD was recorded at 35,6 ± 1,6 weeks and mean interval to delivery was 6,2 ± 5,0 days. Intrauterine/ neonatal death occurred in 10 (10,6%) cases; bowel complications were observed in 8 (8,5%). BTD 15, 20, 25 and 30mm were found in 87, 46, 13 and 4% of pregnancies with a favorable outcome, respectively. BTD 25 mm sensitivity was 38%, positive and negative predictive values, 38% and 87%. For BTD 30 mm, the values were: 19, 50 and 85%. Observed/expected BTD ROC curve showed an area of 0,67, with best cut-off at 1,39; prediction values were similar to those for BTD 25 mm. Bowel dilatation was also significantly associated with lower rate of primary surgical closure, longer period to full oral feeding and prolonged hospital stay. Conclusions: Bowel dilatation demonstrated up to 3 weeks before delivery is a predictor of intestinal complications and is associated with lower rate of primary surgical closure, longer period to achieve full oral feeding and hospital stay

ASSUNTO(S)

bowel diameter diagnóstico pré-natal diâmetro da alça intestinal dilatação dilation feto fetus gastroschisis prenatal diagnosis prognóstico ultrasound ultrassonografia gastrosquise outcome

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