A dilated fetal stomach predicts a complicated postnatal course in cases of prenatally diagnosed gastroschisis.
OBJECTIVE
The purpose of this study was to determine whether dilation of the fetal stomach is associated with increased perinatal complications in infants with prenatally diagnosed gastroschisis.


METHODS
From 34 newborn infants with gastroschisis who were delivered at our institution over a 10-year period, 2 groups were analyzed on the basis of the presence or absence of a dilated fetal stomach. Reactive versus nonreactive nonstress test results were recorded, when performed. Neonatal outcomes were compared.


RESULTS
Twenty-one fetuses had no evidence of gastric dilation. Thirteen fetuses had a dilated fetal stomach that was identified by ultrasound scanning. Within this group there was a higher incidence of nonreactive nonstress tests (P=.01). Infants with a prenatally dilated stomach had a higher incidence of volvulus and neonatal death, a significantly delayed time to full oral feeds, and a longer hospitalization than those infants who did not have a prenatally dilated stomach (P <or=.05).


CONCLUSIONS
Postnatal morbidity and mortality rates are increased in infants with gastroschisis who have a prenatally dilated stomach. These fetuses, although not acidotic at delivery, also had a higher incidence of nonreactive nonstress test results.
Aina-Mumuney
Abimbola J
AJ
Departments of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Fischer
Anne C
AC
Blakemore
Karin J
KJ
Crino
Jude P
JP
Costigan
Kathleen
K
Swenson
Kerry
K
Chisholm
Christian A
CA
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D013271:Gastric Dilatation / Q000000981:diagnostic imaging*; D020139:Gastroschisis / Q000150:complications* / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D011181:Postnatal Care; D011237:Predictive Value of Tests; D011247:Pregnancy; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal