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Can fetal magnetic resonance imaging aid prognosis in gastroschisis: A multicenter study
Camille Codaccioni1, Pierre Macé2, Guillaume Gorincour3
1Centre Pluridisciplinaire de Diagnostic Prénatal, Hopital Timone Enfants, Assistance Publique Hôpitaux de Marseille AP-HM, Aix Marseille Université AMU, France.
Objective:
To assess the contribution and impact of fetal magnetic resonance imaging (MRI) in managing fetal gastroschisis.
Methods:
We conducted an observational retrospective study of gastroschisis patients at three fetal medicine centers from 2008 to 2019. The primary endpoint was the number of cases in which the MRI provided relevant information related to gastroschisis.
Results:
A total of 189 patients were included, and our study group included 38 patients who underwent MRI. For the eight patients with suspected gastroschisis, MRI confirmed the diagnosis. In six cases, it provided additional relevant information (spiral turn, intestine ischemia, and bowel size discrepancy). For the 17 patients with ultrasound signs of additional gastrointestinal anomalies, MRI detected one case of unidentified complex gastroschisis on sonography. For the 13 patients undergoing routine MRI, no significant information was obtained. One termination of pregnancy and one fetoscopy were performed a few days after the MRI results. There was no subsequent follow-up or additional bowel complications to support management.
Conclusion:
Although MRI did not change the management of pregnancies complicated by fetal gastroschisis, patients presenting with fetal gastroschisis with intraabdominal bowel dilatation could benefit from MRI to allow for more precise prenatal counseling to predict postnatal intestinal complications before birth.
Insights
Fetal magnetic resonance imaging (MRI) did not alter management for fetal gastroschisis. However, MRI can offer valuable prenatal insights into potential bowel complications for improved counseling.
Area of Science:
- Medical imaging
- Fetal medicine
- Neonatal surgery
Background:
- Gastroschisis is a congenital abdominal wall defect.
- Accurate prenatal diagnosis and management are crucial for fetal gastroschisis.
- Fetal magnetic resonance imaging (MRI) is increasingly used in prenatal diagnosis.
Purpose of the Study:
- To evaluate the contribution and impact of fetal MRI in managing fetal gastroschisis.
- To assess if fetal MRI provides relevant information for clinical decision-making in gastroschisis cases.
Main Methods:
- Observational retrospective study across three fetal medicine centers (2008-2019).
- Inclusion of 189 gastroschisis patients, with 38 undergoing fetal MRI.
- Primary endpoint: MRI's provision of relevant gastroschisis-related information.
Main Results:
- MRI confirmed suspected gastroschisis in 8 patients.
- Additional relevant findings (e.g., intestinal ischemia, bowel size discrepancy) were noted in 6 cases.
- MRI identified one complex gastroschisis case not evident on sonography; routine MRIs provided no significant information.
Conclusions:
- Fetal MRI did not alter pregnancy management for gastroschisis in this cohort.
- MRI may enhance prenatal counseling by predicting postnatal intestinal complications, particularly in cases with intraabdominal bowel dilatation.
