title: Can antenatal ultrasounds help predict postnatal outcomes in babies born with gastrochisis? The West Virginia experience.
abstract: OBJECTIVE
  Gastrochisis is a congenital condition resulting in significant morbidity and mortality. Multiple studies have been done to evaluate the value of prognostic indicators with conflicting results. The aim of this study was to evaluate the role of ultrasound in this condition at a single institution while limiting the provider variables that may affect neonatal outcome.
  
  
  METHODS
  The antepartum charts of expectant mothers of affected fetuses as well as the neonatal hospital charts were reviewed at length. The cases were identified over a period of 4 years from April 1998 to February 2002. In addition, the archived photographs of ultrasounds performed on these fetuses were also reviewed and reread by two independent providers who were blinded to the outcome. Adverse neonatal outcome, including death and time to feeding (amongst many other variables) were assessed against the different ultrasound parameters including bowel thickness and dilation.
  
  
  RESULTS
  25 patients were identified in the stated time frame. Six cases had to be dropped from the final analysis due to incomplete data including the transfer of 3 babies. There were 4 neonatal deaths. The mean birth weight was 2384 grams. There was a significant association with dilation and delta dilation (defined as the difference in bowel dilation from the final ultrasound from the baseline ultrasound cutoff of 4 mm) and time to feeding, time on ventilator and hospital stay. (P< 0.005). Other ultrasound parameters were not significantly correlated with neonatal outcome.
  
  
  CONCLUSIONS
  Most ultrasound parameters do not help prognosticate the neonatal outcome in babies affected with this condition except for dilation and delta dilation, which are strong predictors of morbidity in the post delivery period. This information may be helpful to providers and parents of affected fetuses.
authors.affiliation: Department of Obstetrics and Gynecology, West Virginia University, P.O. Box 9186, Morgantown, WV 26505, USA. jajezfj@hotmail.com
authors.forename: Jabin
authors.initials: J
authors.lastname: Janoo
authors.forename: Micheal
authors.initials: M
authors.lastname: Cunningham
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Hobbs
authors.forename: Angela
authors.initials: A
authors.lastname: O'Bringer
authors.forename: Maria
authors.initials: M
authors.lastname: Merzouk
mesh_terms: D001724:Birth Weight; D005260:Female; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014903:West Virginia; D055815:Young Adult