title: Sonographic Markers in the Prediction of Fetal Complex Gastroschisis.
abstract: OBJECTIVE
  To investigate the ultrasound (US) markers predictive of complex gastroschisis (CG), mortality, and morbidity in fetuses with gastroschisis.
  
  
  METHODS
  This was a retrospective cohort study of 186 pregnancies with isolated fetal gastroschisis. Eight US markers were analyzed. The predictions and associations of US markers with CG, mortality, and morbidity were assessed. Combinations of US markers predictive of CG were investigated.
  
  
  RESULTS
  Extra-abdominal bowel dilatation (EABD), intra-abdominal bowel dilatation (IABD), and polyhydramnios were predictive of CG. EABD between 25 and 28 weeks had a sensitivity of 64%, a specificity of 89%, a positive predictive value (PPV) of 56.2%, and negative predictive value (NPV) of 91.8%. The predictions of IABD were sensitivity = 26.7%, specificity = 96.7%, PPV = 61.5%, and NPV = 86.8%. The odds ratios for CG in the presence of 1 and 2 US markers, compared with the absence of a US marker, were 18.3 (95% CI, 3.83-87.64) and 73.3 (95% CI, 6.14-876), respectively.
  
  
  CONCLUSIONS
  US markers predictive of CG were established. The combination of these markers increases the probability of CG.
authors.affiliation: Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, Brazil.
authors.forename: Walkyria S
authors.initials: WS
authors.lastname: Andrade
authors.forename: Maria L
authors.initials: ML
authors.lastname: Brizot
authors.forename: Agatha S
authors.initials: AS
authors.lastname: Rodrigues
authors.forename: Ana C
authors.initials: AC
authors.lastname: Tannuri
authors.forename: Vera L
authors.initials: VL
authors.lastname: Krebs
authors.forename: Estela N
authors.initials: EN
authors.lastname: Nishie
authors.forename: Rossana P V
authors.initials: RPV
authors.lastname: Francisco
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000293:Adolescent; D004108:Dilatation, Pathologic; D005260:Female; D005313:Fetal Death; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007422:Intestines / Q000002:abnormalities / Q000000981:diagnostic imaging*; D009336:Necrosis; D016017:Odds Ratio; D054238:Perinatal Mortality; D006831:Polyhydramnios / Q000000981:diagnostic imaging / Q000401:mortality; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013270:Stomach / Q000002:abnormalities / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult
keywords: Bowel atresia; Bowel dilatation; Bowel necrosis; Bowel perforation; Bowel stenosis; Complex gastroschisis; Fetal gastroschisis; Prenatal ultrasound markers