Clinical significance of prenatal ultrasonographic intestinal dilatation in fetuses with gastroschisis

OBJECTIVE: Our purpose was to evaluate the clinical significance of intestinal dilatation detected by prenatal ultrasonographic examination in fetuses with gastroschisis. STUDY DESIGN: A retrospective chart review was performed of all patients cared for at Los Angeles County/University of Southern California Women's and children's Hospital with the prenatal diagnosis of gastroschisis over a 7-year period (1988 through 1995). Patients were divided into two groups on he basis of the presence or absence of ultrasonographically measured fetal bower diameter of greater than or equal to 17 mm. Neonatal outcomes of the two groups were compared. RESULTS: Twenty-one patients met the entry criteria during the study period. Fetuses with maximal bowel diameter of greater than or equal to 17 mm did not have a longer time to full oral feeding, a longer initial hospital stay, or a greater need for bowel resection when compared with fetuses with a bower diameter <17 mm. Two newborns underwent bower resection because of intestinal atresia. Prenatal ultrasonographic examination failed to show significant bowel dilatation in either infant. CONCLUSION: Our data suggest that prenatal evidence of intestinal dilatation in fetuses with gastroschisis does not predict immediate neonatal outcome. Thus this finding is not an appropriate indication for preterm delivery in the absence of other evidence of fetal compromise.