title: Diagnostic Accuracy of Prenatal Ultrasound in Identifying Jejunal and Ileal Atresia.
abstract: BACKGROUND
  Small bowel atresia (SBA) is one of the most common causes of congenital intestinal obstruction. However, the accuracy of prenatal ultrasound in diagnosing this condition has not been entirely ascertained. The aim of this study was to analyse the predictive accuracy of ultrasound in detecting SBA prenatally.
  
  
  METHODS
  Retrospective study of all cases with prenatal suspicion or postnatal confirmed SBA seen in a tertiary fetal medicine and pediatric surgery units from 2007 to 2013. Cases with duodenal atresia were excluded from the study. The predictive accuracy of ultrasound and different ultrasound signs, alone and in combination, was calculated.
  
  
  RESULTS
  65 fetuses with prenatal suspicion or postnatal confirmed SBA were enrolled. 58 cases had full data and were included in the analysis. Predictive accuracy of ultrasound in detecting the presence of SBA was poor, with a sensitivity of 50% (95% CI 26.0-74.0) and a specificity of 70.59% (95% CI 52.5-84.9). The presence of both bowel dilatation ≥17 mm and polyhydramnios after 32 weeks of gestation slightly increased sensitivity (66.67%, 95% CI 34.9-90.1) and specificity (80.00%, 95% CI 44.4-97.5).
  
  
  CONCLUSIONS
  In case of suspicion of SBA before the 3rd trimester, an ultrasound after 32 weeks should be performed to confirm the presence of both polyhydramnios and bowel dilatation >17 mm.
authors.affiliation: Department of Paediatric and Neonatal Surgery, St. George's Healthcare NHS Trust and University of London, London, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: John
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Antonio
authors.forename: Asma
authors.initials: A
authors.lastname: Khalil
authors.forename: Sarah
authors.initials: S
authors.lastname: Bradley
authors.forename: Stefano
authors.initials: S
authors.lastname: Giuliani
mesh_terms: D005260:Female; D006801:Humans; D007082:Ileum / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D007409:Intestinal Atresia / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000002:abnormalities* / Q000000981:diagnostic imaging; D007583:Jejunum / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods* / Q000592:standards