Outcome of fetal gastro-intestinal cysts: a systematic review and meta-analysis.
OBJECTIVE
To explore the outcome of fetal gastrointestinal (GI) cysts and to ascertain the detection rate of prenatal ultrasound in identifying these anomalies.


METHODS
Medline and Embase databases were searched. The outcomes explored were: resolution of the cyst, additional GI anomalies detected only at birth, clinical symptoms, need for surgery, post-surgical complications and diagnostic accuracy. Meta-analyses of proportions and hierarchical summary receiver operating characteristics (HSROC) model were used to analyse the data.


RESULTS
Ten studies were included; 27.0% (95% CI 2.6-64.4) of the cysts resolved either pre or post-natally. Additional GI anomalies were detected in 6.0% (95% CI 1.1-14.7). Clinical symptoms occurred in 31.1% (95% CI 14.9-50.2), while 50.6% (95% CI 10.0-90.8) had surgery. Post-surgical complications occurred in 6.1% (95% CI 0.2-19.6). Overall detection rate of prenatal ultrasound in correctly identifying GI cysts was good (sensitivity: 94.5%, 95% CI: 39.1-99.8; specificity: 97.7%, 95% CI 89.9-99.5).


CONCLUSIONS
GI cysts are usually benign. Clinical symptoms occur in approximately one third of children. About one third of the cysts resolves, while the rate of complications after surgery is low. Prenatal ultrasound has an overall good diagnostic accuracy in identifying these anomalies. © 2016 John Wiley & Sons, Ltd.
Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Italy.
Luisa
L
Marrone
Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Italy.
Marco
M
Liberati
Fetal Medicine Unit, Division of Developmental Sciences, St. George's University of London, London, UK.
Asma
http://orcid.org/0000-0003-2802-7670
A
Khalil
Department of Obstetrics and Gynaecology, University of Rome, Rome, Italy.
Giuseppe
http://orcid.org/0000-0002-5525-4353
G
Rizzo
Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Italy.
Martina
M
Leombroni
Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Italy.
Danilo
D
Buca
Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Italy.
Francesca
F
Bascietto
Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Italy.
Sarah
S
Gustapane
Department of Medicine and Aging Sciences, University of Chieti-Pescara, Italy.
Maria Elena
ME
Flacco
Department of Medicine and Aging Sciences, University of Chieti-Pescara, Italy.
Lamberto
http://orcid.org/0000-0002-8129-9344
L
Manzoli
Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway.
Ganesh
G
Acharya
Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway. francesco.dantonio@uit.no.
Francesco
F
D'Antonio
D003560:Cysts / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D012075:Remission, Spontaneous; D016216:Ultrasonography, Prenatal