title: Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis.
abstract: BACKGROUND
  The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life.
  
  
  METHODS
  In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL).
  
  
  RESULTS
  Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%.
  
  
  CONCLUSIONS
  Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.
authors.affiliation: Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, CHU Sainte-Justine, Universitx00E9; de Montrx00E9;al, Montreal, Que., Canada.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Martillotti
authors.forename: Isabelle
authors.initials: I
authors.lastname: Boucoiran
authors.forename: Amélie
authors.initials: A
authors.lastname: Damphousse
authors.forename: Andrée
authors.initials: A
authors.lastname: Grignon
authors.forename: Eric
authors.initials: E
authors.lastname: Dubé
authors.forename: Ahmed
authors.initials: A
authors.lastname: Moussa
authors.forename: Sarah
authors.initials: S
authors.lastname: Bouchard
authors.forename: Lucie
authors.initials: L
authors.lastname: Morin
mesh_terms: D000328:Adult; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D058535:Echogenic Bowel / Q000000981:diagnostic imaging; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D020139:Gastroschisis / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007422:Intestines / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D016216:Ultrasonography, Prenatal