CLINICAL-SIGNIFICANCE OF PRENATAL ULTRASONOGRAPHIC INTESTINAL DILATATION IN FETUSES WITH GASTROSCHISIS

OBJECTIVE: Our purpose was to evaluate the clinical significance of in testinal dilatation detected by prenatal ultrasonographic examination in fetuses with gastroschisis. STUDY DESIGN: A retrospective chart rev iew was performed of all patients cared for at Los Angeles County/Univ ersity of Southern California Women's and children's Hospital with the prenatal diagnosis of gastroschisis over a 7-year period (1988 throug h 1995). Patients were divided into two groups on he basis of the pres ence 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 du ring 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 resectio n when compared with fetuses with a bower diameter <17 mm. Two newborn s underwent bower resection because of intestinal atresia. Prenatal ul trasonographic 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 predi ct immediate neonatal outcome. Thus this finding is not an appropriate indication for preterm delivery in the absence of other evidence of f etal compromise.