title: Prenatal sonographic ultrasound predictors for the outcome in fetal gastroschisis: a retrospective analysis.
abstract: OBJECTIVE
  To identify predictive ultrasound signs for unfavorable outcome in fetal gastroschisis (GS).
  
  
  METHODS
  This is a retrospective cohort study among pregnant women with the prenatal diagnosis of GS between 1998 and 2011 at the University of Wuerzburg, Germany. Analysis included prenatal ultrasound scans, neonatal intensive care unit (NICU) records, and pediatric records. The collected variables included maternal and fetal demographics, as well as an analysis of predictors for unfavorable fetal outcome. Unfavorable outcome was defined by more than 2 postnatal surgical interventions, intestinal resections, and long time to oral feeding (≥4 weeks).
  
  
  RESULTS
  35 cases of fetal GS were diagnosed, whereby 23 cases met the inclusion criteria and were evaluated by prenatal ultrasound and postnatal outcome. Based on the postnatal situation, 15 patients were classified in a good prognosis group and 8 patients in a poor prognosis group. Fetuses with poor prognosis were presented later during pregnancy (21.1 ± 6 vs. 26.9 ± 5.3 weeks; p < 0.01) and delivered at earlier gestational age (35.6 ± 0.8 vs. 33.4 ± 1.4 weeks; p < 0.01) with lower birth weight (2074 ± 306.3 vs. 2559 ± 255.4 g; p < 0.01). There were no differences in prenatal findings like growth restriction, amniotic fluid index, or Doppler results between good and poor prognosis group. However, early detected and long-lasting bowel dilatation was associated with poor prognosis.
  
  
  CONCLUSIONS
  Late presentation and early gestational age at delivery are associated with poor prognosis in neonates with GS. Furthermore, early onset as well as long duration of bowel dilatation is associated with poor fetal outcome, while other ultrasound characteristics are not able to predict poor prognosis of GS.
authors.affiliation: Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany. Stueber_T@ukw.de.
authors.forename: Tanja Nadine
authors.initials: TN
authors.lastname: Stüber
authors.affiliation: Children`s Hospital, University of Wuerzburg, Josef-Schneider-Str. 2, 97080, Wuerzburg, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Frieauff
authors.affiliation: Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany.
authors.forename: Claire
authors.initials: C
authors.lastname: Weiß
authors.affiliation: Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Zollner
authors.affiliation: Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Wöckel
authors.affiliation: Department of Paediatric Surgery, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meyer
authors.affiliation: Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Rehn
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000000981:diagnostic imaging*; D002648:Child; D015331:Cohort Studies; D005260:Female; D020139:Gastroschisis / Q000175:diagnosis* / Q000601:surgery; D005858:Germany; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
keywords: Bowel dilatation; Fetal outcome; Gastroschisis; Prenatal diagnosis