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Fetal gastrointestinal malformations
V Dadhwal1, S Kochhar, S Mittal
1Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi.
Insights
Fetal gastrointestinal malformations often present with other anomalies and require specialized neonatal surgical care. Prenatal ultrasound accuracy for diagnosing these conditions was limited in this study.
Area of Science:
- Perinatal Medicine
- Fetal Surgery
- Neonatology
Background:
- Gastrointestinal (GIT) malformations in newborns present significant perinatal challenges.
- Accurate prenatal diagnosis and management planning are crucial for improving outcomes.
Purpose of the Study:
- To audit fetal gastrointestinal malformations.
- To evaluate prenatal diagnosis accuracy and perinatal management strategies.
Main Methods:
- Retrospective audit of case sheets for mothers delivering newborns with GIT malformations.
- Analysis of maternal history, prenatal ultrasound findings, postnatal malformations, and perinatal management.
Main Results:
- Eleven newborns had GIT malformations; one was stillborn.
- Nine newborns had associated malformations; two had trisomy 21.
- Prenatal ultrasound showed limited accuracy in diagnosing GIT anomalies.
- Eight newborns underwent immediate surgery, with five survivors.
Conclusions:
- Fetal gastrointestinal malformations frequently involve chromosomal and structural anomalies, warranting fetal echocardiography and genetic amniocentesis.
- Optimal management requires delivery in centers with advanced neonatal and pediatric surgical care due to the high incidence of immediate surgical needs.
Abstract:
In an audit to evaluate fetal gastrointestinal (GIT) malformations, case sheets of all mothers who gave birth to newborns with GIT malformations were analysed regarding the maternal history, prenatal ultrasound and the postnatal structural malformations and perinatal management. In 1999, eleven babies were born with gastrointestinal malformations, one was a still birth. Nine had associated malformations of other systems, two had trisomy 21. Eight babies were operated in the immediate newborn period, 5 survived. Ultrasound was not very accurate in the diagnosis of GIT anomaly in this series. In view of associated chromosomal and structural anomaly a fetal ECHO and genetic amniocentesis is warranted. Most of these babies require immediate surgery after birth, so they need to be delivered in a centre which is equipped with good neonatal and pediatric surgery care.