title: Antenatal diagnosis of bowel dilatation in gastroschisis is predictive of poor postnatal outcome.
abstract: OBJECTIVE
  Although gastroschisis infants usually have a good outcome, there remains a cohort of babies who fare poorly. We inquired whether the presence of bowel dilatation in utero is predictive of postnatal course in infants with gastroschisis.
  
  
  METHODS
  We compared the clinical course of infants who had bowel dilatation with those who did not. Bowel dilatation was defined as more than 20 mm in cross-sectional diameter on ultrasound at any gestational age. Outcome measures used were length of time of parenteral nutrition, death, and surgery for intestinal failure.
  
  
  RESULTS
  A review of 170 infants with gastroschisis identified 74 who had dilatation of more than 20 mm (43.5%). There was no significant difference in the incidence of intestinal atresia in those with bowel dilatation and those without (P = .07). Those with bowel dilatation spent a longer period on parenteral nutrition. There were significantly more deaths in the group with bowel dilatation (P = .01). There was no significant difference in the number of infants requiring surgery for intestinal failure between the 2 groups (P = .47).
  
  
  CONCLUSIONS
  We found that sonographically detected bowel dilatation more than 20 mm in utero in fetuses with gastroschisis may have value in predicting clinically significant adverse postnatal outcomes.
authors.affiliation: Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom.
authors.forename: Anna-May
authors.initials: AM
authors.lastname: Long
authors.forename: Joanne
authors.initials: J
authors.lastname: Court
authors.forename: Antonino
authors.initials: A
authors.lastname: Morabito
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Gillham
mesh_terms: D015331:Cohort Studies; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000401:mortality; D005260:Female; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D007410:Intestinal Diseases / Q000151:congenital / Q000000981:diagnostic imaging* / Q000401:mortality*; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal