title: Prenatal diagnosis and outcome of fetal gastrointestinal obstruction.
abstract: BACKGROUND
  The purpose of this study was to evaluate the accuracy of prenatal diagnosis for fetuses with gastrointestinal (GI) obstruction with correlation to postnatal outcomes.
  
  
  METHODS
  Fetuses diagnosed with GI obstruction (excluding esophageal and duodenal) were reviewed for those evaluated between 2006 and 2016. Prenatal diagnosis and imaging studies were compared to postnatal findings. Outcomes evaluated included diagnostic accuracy, rate of other anomalies, neonatal length of stay, incidence of short bowel syndrome, and discharge with TPN or gastrostomy.
  
  
  RESULTS
  Forty-eight patients were diagnosed prenatally with obstruction. Six patients were excluded owing to incomplete records and follow-up. Twelve fetuses were diagnosed with ultrasound alone, and thirty-four with ultrasound and MRI. A diagnosis of obstruction was accurate in 88.1% (n=37/42) with a positive predictive value of 91.3%, while US with MRI had an accuracy of 84.4%. Associated anomalies were highest among fetuses with anorectal obstruction (90.1%), compared to large (50%) or small bowel obstruction (28%). Survival rate was lowest for anorectal obstruction (54.5%), compared to large or small bowel obstruction (100% for both).
  
  
  CONCLUSIONS
  Fetal MRI is an accurate modality in the diagnosis of fetal GI obstruction and can complement findings characterized by ultrasound. Fetuses with anorectal obstruction have a higher rate of associated anomalies and the lowest survival.
  
  
  METHODS
  IIb.
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Surgery, Houston, TX.
authors.forename: Patricio E
authors.initials: PE
authors.lastname: Lau
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Surgery, Houston, TX.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cruz
authors.affiliation: Baylor College of Medicine Department of Radiology, Houston, TX.
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Cassady
authors.affiliation: Baylor College of Medicine Department of Radiology, Houston, TX.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Mehollin-Ray
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Obstetrics and Gynecology, Houston, TX.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ruano
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Surgery, Houston, TX; Baylor College of Medicine Department of Obstetrics and Gynecology, Houston, TX.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Keswani
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Surgery, Houston, TX.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Lee
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Surgery, Houston, TX; Baylor College of Medicine Department of Radiology, Houston, TX; Baylor College of Medicine Department of Obstetrics and Gynecology, Houston, TX.
authors.forename: Oluyinka O
authors.initials: OO
authors.lastname: Olutoye
authors.affiliation: Texas Children's Fetal Center, Houston, TX; Baylor College of Medicine Department of Surgery, Houston, TX; Baylor College of Medicine Department of Radiology, Houston, TX; Baylor College of Medicine Department of Obstetrics and Gynecology, Houston, TX. Electronic address: DLCass@texaschildrens.org.
authors.forename: Darrell L
authors.initials: DL
authors.lastname: Cass
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000151:congenital / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D010289:Parenteral Nutrition, Total; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods
keywords: Congenital bowel obstruction; Fetal MRI, fetal imperforate anus; Gastrointestinal abnormalities; Prenatal diagnosis