title: Accuracy of prenatal ultrasound in detecting jejunal and ileal atresia: systematic review and meta-analysis.
abstract: OBJECTIVE
  The accuracy of prenatal ultrasound examination in detecting jejunal and ileal atresia has been reported in the literature to be highly variable, at 25-90%. The aim of this systematic review was to evaluate the accuracy of prenatal ultrasound in detecting non-duodenal small bowel atresia (ND-SBA).
  
  
  METHODS
  MEDLINE, EMBASE and The Cochrane Library, including The Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and The Cochrane Central Register of Controlled Trials (CENTRAL), were searched electronically. The overall detection rate of jejunal or ileal atresia using ultrasound was reported. The accuracy of using polyhydramnios and dilated loops of bowel as diagnostic signs was also explored.
  
  
  RESULTS
  Sixteen studies involving 640 fetuses were included in this review. The detection rate of ND-SBA by prenatal ultrasound was highly variable, with values ranging from 10 to 100%, with an overall prediction of 50.6% (95% CI, 38.0-63.2%). When analyzed separately, the detection rates of jejunal and ileal atresia were 66.3%, (95% CI, 33.9-91.8%) and 25.9% (95% CI, 4.0-58.0%), respectively. Both dilated loops of bowel and polyhydramnios as diagnostic signs for ND-SBA provided a low overall detection rate.
  
  
  CONCLUSIONS
  The diagnostic performance of prenatal ultrasound in identifying ND-SBA is extremely variable. Large studies are needed in order to identify objective and combined criteria for the diagnosis of these anomalies.
authors.affiliation: Department of Paediatric and Neonatal Surgery, St. George's Healthcare NHS Trust and University of London, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Virgone
authors.forename: F
authors.initials: F
authors.lastname: D'antonio
authors.forename: A
authors.initials: A
authors.lastname: Khalil
authors.forename: R
authors.initials: R
authors.lastname: Jonh
authors.forename: L
authors.initials: L
authors.lastname: Manzoli
authors.forename: S
authors.initials: S
authors.lastname: Giuliani
mesh_terms: D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000196:embryology; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000000981:diagnostic imaging* / Q000196:embryology / Q000473:pathology; D007421:Intestine, Small / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000196:embryology / Q000473:pathology; D007583:Jejunum / Q000000981:diagnostic imaging* / Q000196:embryology; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal
keywords: ileal atresia; jejunal atresia; meta-analysis; non-duodenal small intestinal atresia; prenatal diagnosis; prenatal ultrasound