Congenital duodenal obstruction: the impact of an antenatal diagnosis

Area of Science:

• Pediatric Surgery
• Fetal Medicine
• Neonatology

Background:

• Congenital duodenal obstruction is a significant neonatal surgical emergency.
• Antenatal diagnosis allows for early planning of neonatal surgical interventions.
• The impact of antenatal diagnosis on parental coping and infant outcomes requires further investigation.

Purpose of the Study:

• To evaluate the impact of antenatal diagnosis of congenital duodenal obstruction on parental preparedness and infant outcomes.
• To compare clinical characteristics and surgical outcomes between antenatally and postnatally diagnosed infants.
• To assess the influence of antenatal diagnosis on the timing of surgical intervention.

Main Methods:

• Retrospective review of 34 infants with congenital duodenal obstruction.
• Analysis of antenatal ultrasound diagnoses, parental counseling, and postnatal management.
• Comparison of birth weight, gestational age, associated anomalies, surgical timing, and survival rates between groups.

Main Results:

• Fifteen of 34 infants were diagnosed with duodenal obstruction antenatally.
• Antenatal diagnosis facilitated parental preparation for neonatal surgery.
• Infants diagnosed antenatally underwent earlier surgical repair, but overall survival rates were similar (88% overall, 94% post-repair).
• Associated congenital anomalies were more frequent in postnatally diagnosed infants.
• No significant difference in mean birth weight or gestational age between antenatal and postnatal diagnosis groups.

Conclusions:

• Antenatal diagnosis of duodenal obstruction positively influences parental coping with the anomaly.
• While antenatal diagnosis leads to earlier surgery, it does not alter the overall outcome for infants with duodenal obstruction.
• Severe associated congenital anomalies remain a primary factor influencing mortality.