Using three-dimensional ultrasound in predicting complex gastroschisis: A longitudinal, prospective, multicenter...

Area of Science:

• Medical imaging
• Fetal medicine
• Pediatric surgery

Background:

• Gastroschisis is a congenital abdominal wall defect with simple and complex forms.
• Complex gastroschisis, involving intestinal atresia or other complications, requires different management.
• Prenatal differentiation between simple and complex gastroschisis is clinically important.

Purpose of the Study:

• To evaluate the utility of fetal stomach volume and stomach-bladder distance measured by 3D ultrasound in differentiating complex gastroschisis from simple gastroschisis.
• To determine if these sonographic parameters can predict the complexity of gastroschisis prenatally.

Main Methods:

• A multicenter prospective cohort study involving four Dutch university medical centers (2010-2015).
• Longitudinal 3D ultrasound measurements of fetal stomach volume (Sonography-based Automated Volume Count) and stomach-bladder distance were performed.
• Linear mixed modeling was used to assess the effect of gestational age and gastroschisis type on these measurements.

Main Results:

• Seventy-nine fetuses with gastroschisis were included; 66 were assessed with 3D ultrasound.
• Fetal stomach volume increased and stomach-bladder distance decreased with advancing gestational age (P < .001).
• No significant differences in the developmental trends of stomach volume (P = .85) or stomach-bladder distance (P = .78) were observed between simple and complex gastroschisis.

Conclusions:

• Fetal stomach volume and stomach-bladder distance, as measured by 3D ultrasonography, are not effective predictors of complex gastroschisis.
• These sonographic parameters do not aid in distinguishing between simple and complex forms of gastroschisis during pregnancy.