TY - JOUR
T1 - Prenatal Sonography in Suspected Proximal Gastrointestinal Obstructions
T2 - Diagnostic Accuracy and Neonatal Outcomes
AU - Engwall-Gill, Abigail J.
AU - Zhou, Alice L.
AU - Penikis, Annalise B.
AU - Sferra, Shelby R.
AU - Jelin, Angie C.
AU - Blakemore, Karin J.
AU - Kunisaki, Shaun M.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/6
Y1 - 2023/6
N2 - Background: The purpose of this study was to assess diagnostic accuracy and neonatal outcomes in fetuses with a suspected proximal gastrointestinal obstruction (GIO). Methods: After IRB approval, a retrospective chart review was conducted on prenatally suspected and/or postnatally confirmed cases of proximal GIO at a tertiary care facility (2012–2022). Maternal-fetal records were queried for presence of a double bubble ± polyhydramnios, and neonatal outcomes were assessed to calculate the diagnostic accuracy of fetal sonography. Results: Among 56 confirmed cases, the median birthweight and gestational age at birth were 2550 g [interquartile range (IQR) 2028–3012] and 37 weeks (IQR 34–38), respectively. There was one (2%) false-positive and three (6%) false-negatives by ultrasound. Double bubble had a sensitivity, specificity, positive predictive value, and negative predictive value for proximal GIO of 85%, 98%, 98%, and 83%, respectively. Pathologies included 49 (88%) with duodenal obstruction/annular pancreas, three (5%) with malrotation, and three (5%) with jejunal atresia. The median postoperative length of stay was 27 days (IQR 19–42). Cardiac anomalies were associated with significantly higher complications (45% vs 17%, p = 0.030). Conclusions: In this contemporary series, fetal sonography has high diagnostic accuracy for detecting proximal gastrointestinal obstruction. These data are informative for pediatric surgeons in prenatal counseling and preoperative discussions with families. Level of Evidence: Diagnostic Study, Level III.
AB - Background: The purpose of this study was to assess diagnostic accuracy and neonatal outcomes in fetuses with a suspected proximal gastrointestinal obstruction (GIO). Methods: After IRB approval, a retrospective chart review was conducted on prenatally suspected and/or postnatally confirmed cases of proximal GIO at a tertiary care facility (2012–2022). Maternal-fetal records were queried for presence of a double bubble ± polyhydramnios, and neonatal outcomes were assessed to calculate the diagnostic accuracy of fetal sonography. Results: Among 56 confirmed cases, the median birthweight and gestational age at birth were 2550 g [interquartile range (IQR) 2028–3012] and 37 weeks (IQR 34–38), respectively. There was one (2%) false-positive and three (6%) false-negatives by ultrasound. Double bubble had a sensitivity, specificity, positive predictive value, and negative predictive value for proximal GIO of 85%, 98%, 98%, and 83%, respectively. Pathologies included 49 (88%) with duodenal obstruction/annular pancreas, three (5%) with malrotation, and three (5%) with jejunal atresia. The median postoperative length of stay was 27 days (IQR 19–42). Cardiac anomalies were associated with significantly higher complications (45% vs 17%, p = 0.030). Conclusions: In this contemporary series, fetal sonography has high diagnostic accuracy for detecting proximal gastrointestinal obstruction. These data are informative for pediatric surgeons in prenatal counseling and preoperative discussions with families. Level of Evidence: Diagnostic Study, Level III.
KW - Double bubble
KW - Polyhydramnios
KW - Proximal gastrointestinal obstruction
UR - http://www.scopus.com/inward/record.url?scp=85150347456&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150347456&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2023.02.029
DO - 10.1016/j.jpedsurg.2023.02.029
M3 - Article
C2 - 36907770
AN - SCOPUS:85150347456
SN - 0022-3468
VL - 58
SP - 1090
EP - 1094
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 6
ER -