A dilated fetal stomach predicts a complicated postnatal course in cases of prenatally diagnosed gastroschisis

Objective: The purpose of this study was to determine whether dilation of the fetal stomach is associated with increased perinatal complications in infants with prenatally diagnosed gastroschisis. Study design: From 34 newborn infants with gastroschisis who were delivered at our institution over a 10-year period, 2 groups were analyzed on the basis of the presence or absence of a dilated fetal stomach. Reactive versus nonreactive nonstress test results were recorded, when performed. Neonatal outcomes were compared. Results: Twenty-one fetuses had no evidence of gastric dilation. Thirteen fetuses had a dilated fetal stomach that was identified by ultrasound scanning. Within this group there was a higher incidence of nonreactive nonstress tests (P =.01). Infants with a prenatally dilated stomach had a higher incidence of volvulus and neonatal death, a significantly delayed time to full oral feeds, and a longer hospitalization than those infants who did not have a prenatally dilated stomach (P less than or equal to 05). Conclusion: Postnatal morbidity and mortality rates are increased in infants with gastroschisis who have a prenatally dilated stomach. These fetuses, although not acidotic at delivery, also had a higher incidence of nonreactive nonstress test results. (C) 2004 Elsevier Inc. All rights reserved.