title: Prenatal diagnosis of duodenal obstruction selects cases with a higher risk of maternal-foetal complications and demands in utero transfer to a tertiary centre.
abstract: OBJECTIVE
  It was the aim of this study to determine if prenatal diagnosis of congenital duodenal obstruction (CDO) selects high-risk pregnancies and demands special perinatal attention.
  
  
  METHODS
  Medical records of 62 neonates with intrinsic CDO, admitted since 1981 in 2 institutions, were reviewed and divided into 2 groups: 39 cases, detected in utero by a prenatal ultrasonogram (group A), and 23 diagnosed at birth (group B). Prevalence of complete CDO, mean gestational age, mean birth weight, hydramnios, as well as maternal-foetal complications requiring emergency Caesarean section and associated with premature delivery were compared in the 2 groups.
  
  
  RESULTS
  A complete CDO was found in 77% of patients in group A versus 48% of patients in group B (p < 0.02). Differences in mean gestational age and mean birth weight in the 2 groups were non-significant. Prenatally diagnosed patients presented a higher prevalence of hydramnios, maternal-foetal complications and premature delivery.
  
  
  CONCLUSIONS
  Prenatal diagnosis selects patients with complete CDO and hydramnios. These pregnancies present a high incidence of maternal-foetal complications, which may require an emergency Caesarean section, and are frequently associated with premature delivery. These aspects must be considered in prenatal counselling. In utero transfer to a tertiary centre for delivery and appropriate perinatal care should be recommended.
authors.affiliation: Paediatric Surgery Division, S. Camillo, Forlanini Hospital, University La Sapienza, Rome, Italy. acalisti@scamilloforlanini.rm.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Calisti
authors.forename: Lucia
authors.initials: L
authors.lastname: Oriolo
authors.forename: Denis Andrew
authors.initials: DA
authors.lastname: Cozzi
authors.forename: Vito
authors.initials: V
authors.lastname: Briganti
authors.forename: Francesco
authors.initials: F
authors.lastname: Morini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pacilli
authors.forename: Philippe
authors.initials: P
authors.lastname: Molle
authors.forename: Lorna
authors.initials: L
authors.lastname: Spagnol
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mangia
authors.forename: Francesco
authors.initials: F
authors.lastname: Cozzi
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology*; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D004380:Duodenal Obstruction / Q000151:congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004386:Duodenum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D010360:Patient Transfer / Q000706:statistics & numerical data; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D016216:Ultrasonography, Prenatal