Using three‐dimensional ultrasound in predicting complex gastroschisis: A longitudinal, prospective, multicenter cohort study

• Published in: Prenatal diagnosis Vol. 39; no. 13; pp. 1204 - 1212
• Main Authors: Hijkoop, Annelieke, Lap, Chiara C.M.M., Aliasi, Moska, Mulder, Eduard J.H., Kramer, William L.M., Brouwers, Hens A.A., Baren, Robertine, Pajkrt, Eva, Kaam, Anton H., Bilardo, Caterina M., Pistorius, Lourens R., Visser, Gerard H.A., Wijnen, René M.H., Tibboel, Dick, Manten, Gwendolyn T.R., Cohen‐Overbeek, Titia E.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2019; John Wiley and Sons Inc
• Subjects: Adult; Bladder; Cohort analysis; Female; Fetuses; Gastroschisis - diagnostic imaging; Gestational age; Health care facilities; Health risk assessment; Humans; Imaging, Three-Dimensional; Intestine; Longitudinal Studies; Necrosis; Original; Perforation; Pregnancy; Prospective Studies; Stomach; Stomach - diagnostic imaging; Stomach - embryology; Ultrasonic imaging; Ultrasonic methods; Ultrasonic testing; Ultrasonography, Prenatal; Ultrasound; Young Adult
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.5568

Objective To determine whether complex gastroschisis (ie, intestinal atresia, perforation, necrosis, or volvulus) can prenatally be distinguished from simple gastroschisis by fetal stomach volume and stomach‐bladder distance, using three‐dimensional (3D) ultrasound. Methods This multicenter prospective cohort study was conducted in the Netherlands between 2010 and 2015. Of seven university medical centers, we included the four centers that performed longitudinal 3D ultrasound measurements at a regular basis. We calculated stomach volumes (n = 223) using Sonography‐based Automated Volume Count. The shortest stomach‐bladder distance (n = 241) was determined using multiplanar visualization of the volume datasets. We used linear mixed modelling to evaluate the effect of gestational age and type of gastroschisis (simple or complex) on fetal stomach volume and stomach‐bladder distance. Results We included 79 affected fetuses. Sixty‐six (84%) had been assessed with 3D ultrasound at least once; 64 of these 66 were liveborn, nine (14%) had complex gastroschisis. With advancing gestational age, stomach volume significantly increased, and stomach‐bladder distance decreased (both P < .001). The developmental changes did not differ significantly between fetuses with simple and complex gastroschisis, neither for fetal stomach volume (P = .85), nor for stomach bladder distance (P = .78). Conclusion Fetal stomach volume and stomach‐bladder distance, measured during pregnancy using 3D ultrasonography, do not predict complex gastroschisis. What's already known about this topic? Infants with complex gastroschisis have a higher risk of morbidity than those with simple gastroschisis. Many attempts have been made to prenatally predict complex gastroschisis, using two‐dimensional ultrasound parameters. What does this study add? This longitudinal prospective multicenter study is the first to evaluate the possible benefit of the use of three‐dimensional ultrasound in fetuses with gastroschisis. Fetal stomach volume and stomach‐bladder distance, measured during pregnancy using three‐dimensional ultrasound, cannot predict complex gastroschisis.