Comparison of Perinatal Outcomes between Patients with Suspected Complex and Simple Gastroschisis.

OBJECTIVE

The aim of this study was to compare perinatal outcomes between patients with and without prenatal ultrasound markers predictive of complex gastroschisis.

STUDY

DESIGN

A prospective cohort of 98 patients with isolated fetal gastroschisis underwent antenatal ultrasound and delivered in a tertiary referral center. Patients were classified according to eight ultrasonographic markers predictive of complexity, and perinatal outcomes were assessed accordingly. The primary outcome was the presence of fetal growth restriction and staged SILO reduction postnatally.

RESULTS

Of all fetuses, 54.1% (n = 53) displayed ultrasonographic markers predictive of complexity at 32.7 ± 4.3 weeks of gestation. Gastric dilatation was the most frequent marker followed by extra-abdominal bowel dilatation. The presence of ultrasound markers predictive of complexity, was not associated with fetal growth restriction but its absence was less associated with staged SILO reduction of the abdominal wall postnatally with a relative risk of 0.79 (CI 95% 0.17-0.53).

CONCLUSION

Fetuses with ultrasound markers that predict complexity were not associated with fetal growth restriction, but its absence was less associated with staged SILO reduction of the abdominal wall postnatally. It is necessary to unify criteria, establish cut-off points, and the optimal moment to measure these markers.

KEY POINTS: · The association between ultrasound markers and adverse perinatal outcomes in fetuses with gastroschisis remain controversial.. · The absence of ultrasound markers that predict complexity was less associated with staged SILO reduction postnatally.. · It is necessary to unify criteria, establish cut-off points, and the optimal moment to measure these markers..