PERINATOLOGIYA I PEDIATRIYA. 2016.2(66):70-76; doi 10.15574/PP.2016.66.70 
 

Prenatal diagnosis of gastroschisis in fetuses and newborns 
 

Slyepov O. K., Gordienko I. Yu., Veselskiy V. L., Tarapurova O. M., Hrebinichenko G. O., Soroka V. P., Ponomarenko O. P., Velychko A. V.

SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS of Ukraine», Kiev

National Academy of Medical Sciences of Ukraine, Kiev, Ukraine 
 

Objective — to develop and improve the nature and extent of prenatal and early postnatal diagnosis of gastroschisis in fetuses and newborns.

Patients and methods. For the period 2006–2015 yy. in SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS Ukraine» prenatally have been examined 43 fetuses with gastroschisis. During the prenatal fetal examinations with gastroschisis in addition to the ultrasound specialists obligatory was present pediatric surgeon.

Results. At 100% operated newborns with gastroschisis diagnosis was established prenatally. The frequency of early prenatal diagnosis of gastroschisis (up to 22 weeks gestation) — 43.6%, which requires further improvements.

Conclusions. The main criteria for prenatal diagnosis of gastroschisis in the fetus are: the localization and size of the through defect of anterior abdominal wall, character of eventrated organs, their condition and amount; the volume of the abdominal cavity and the degree visceroabdominal imbalances; definition of associated malformations and diseases; the amount of amniotic fluid; cytogenetic examination with the definition of fetal karyotype. The algorithm of postnatal diagnosis of gastroschisis and associated malformations of diseases in newborn includes: ultrasound investigation of the abdomen and extra-abdominal areas; echocardiography and cranial ultrasonography; plain radiography of the chest and abdomen, contrast passage through the gastrointestinal tract, ergography — for suspected intestinal obstruction; neurologist consultation, and if necessary — consultation of other professionals.

Key words: newborns, gastroschisis, prenatal diagnosis, postnatal diagnosis.

REFERENCES

1. Bisaliev BN. 2011. Optimizatsiya lecheniya gastroshizisa. Dis. k.med.n. Moskva: 120.

2. Plohih DA. 2007. Hirurgicheskoe lechenie gastroshizisa s vistsero-abdominalnoy disproportsiey. Dis. k.med.n. Kemerovo: 22.

3. Slyepov OК, Hrasyukova NІ, Soroka VP, Ponomarenko OP. 2014. The comparative characteristic of an anatomical features and condition of the eventrated organs at gastroschisis among naturally born babies and by cesarean section. Perinatologiya i pediatriya. 3(59): 16—20.

4. Tarapurova OM, GordIEnko IYu, NIkItchina TV ta In. 2006. Prenatalna dIagnostika ta vedennya vagItnostI pri vrodzhenih vadah rozvitku perednoYi cherevnoYi stInki u ploda. Ultrazvukova perinatalna dIagnostika. 2: 59—71.

5. Sliepov OK, Veselskyi VL, Hrasiukova NI. 2014. Chastota i prychyny smertnosti novonarodzhenykh ditei iz hastroshyzysom. Khirurhiia dytiachoho viku. 3(4): 81—87.

6. Gibbin C, Tonch S, Broth RE et al. 2003. Abdominal wall defects and congenital heart disease. Ultrasound Obstet. Gynecol. 21: 334—337. http://dx.doi.org/10.1002/uog.93; PMid:12704739

7. Bianchi A, Dickson A. 1998. Elective delayed reduction and no anesthesia: minimal intervention management for gastroschisis. J Pediatr Surg. 53; 9: 1338—1340. http://dx.doi.org/10.1016/S0022-3468(98)90002-1

8. Cedergen M, Selbing A. 2006. Detection of fetal structural abnormalities by an 11 — 14 week ultrasound dating scan in an unselected Swedish population. Acta Obstet Gynecol Scand. 85: 912—915. http://dx.doi.org/10.1080/00016340500448438; PMid:16862467

9. Chabra S. 2006. Management of gastroschisis: prenatal, perinatal and neonatal. Neoreviews. 7: 419—427. http://dx.doi.org/10.1542/neo.7-8-e419

10. David AL, Tan A, Curry J. 2008. Gastroschisis: conographic diagnosis, associations, management and outcome. Prenatal Diagn. 29: 633—644. http://dx.doi.org/10.1002/pd.1999; PMid:18551719

11. Murphy FL, Mazlan JA, Jarheen F et al. 2007. Gastroschisis and exomphalos in Ireland 1998—2004. Does antenatal diagnosis impact on ontcome? Pediatr Surg Int. 23: 1059—1063. http://dx.doi.org/10.1007/s00383-007-2001-z; PMid:17701414

12. Feldkamp ML, Carey JC, Sadler TW. 2007. Development of gastroschisis: review of hypotheses, novel hypothesis, and implications for research. Am J Med Genet. 143A: 639—652. http://dx.doi.org/10.1002/ajmg.a.31578; PMid:17230493

13. Holland AJA, Walker K, Badanti N. 2010. Gastroschisis an update. Pediatr Surg Int. 26: 871-878. http://dx.doi.org/10.1007/s00383-010-2679-1; PMid:20686898

14. Kazanra M, Sic R, Irgens S et al. 2004. Increasing risk of gastroschisis in Norway: an age-period-cohort analysis. Am J Epidemiol. 159; 4: 358—363. http://dx.doi.org/10.1093/aje/kwh051

15. Islam S. 2008. Clinical care outcomes in abdominal wall defects. Curr Opin Pediatr. 20: 305—310. http://dx.doi.org/10.1097/MOP.0b013e3282ffdc1e; PMid:18475100

16. Kohl T, Tchatcheva K, Stressig R et al. 2009. Is there a therapeutic role for fetoscopic surgery in the prenatal treatment of gastroschisis? A feasibility study in sheep. Surg Endosc. 23: 1499—1505. http://dx.doi.org/10.1007/s00464-009-0394-6; PMid:19263117

17. Joane M, Dolk H, Bradbury I. 2007. Increasing prevalence of gastroschisis in Europe 1980—2002: a phenomen restricted to younger mothers? Paediatr Perinat Epidemiol. 21: 363—369. http://dx.doi.org/10.1111/j.1365-3016.2007.00820.x; PMid:17564594

18. Joo JG, Csatlos E, Rigo JJz. 2010. Abdominal wall malformations in a 15 — year fetopatological study: accuracy of prenatal ultrasonography diagnosis. Prenat Diagn. 30: 1015—1018. http://dx.doi.org/10.1002/pd.2515; PMid:20925045

19. Kronfli R, Bradnock TJ, Sabharwal A. 2010. Intestinal atresia in association with gastroschisis: a 26 — year review. Pediatr Surg Int. 26: 891—894. http://dx.doi.org/10.1007/s00383-010-2676-4; PMid:20676892

20. Nicholas S, Tunli MG, Dicke J et al. 2010. Estimation of fetal weight in fetuses with abdominal wall defects comparison of 2 recent sonographic formulas to formula. J Ultrasound Med. 29: 1069—1074. PMid:20587430

21. Lao OB, Larison C, Garrison MM et al. 2010. Outcomes in neonates with gastroschisis in U. S. children's hospitals. Am J Perinatal. 27: 97—101. http://dx.doi.org/10.1055/s-0029-1241729; PMid:19866404 PMCid:PMC2854024

22. D'Antonio, Virgone C, Rizzo G et al. 2015. Prenatal risk factors and outcomes in gastroschisis: a meta-analysis. Pediatrics. 136: 159—169. http://dx.doi.org/10.1542/peds.2015-0017; PMid:26122809

23. Reid K, Dickinson J, Donerty D. 2003. The epidemiologic incidents of congenital gastroschisis in Western Australia. Am J Obstet Gynecol. 189; 3: 764—768. http://dx.doi.org/10.1067/S0002-9378(03)00819-6

24. Davis RP, Treadwell MC, Drongowski RA et al. 2009. Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome? Pediatr Surg Int. 25: 319—325. http://dx.doi.org/10.1007/s00383-009-2342-x; PMid:19277683

25. Cohen-Overbeck TE, Hartmann TR, Stugers EA et al. 2008. The outcome of gastroschisis after a prenatal diagnosis or a diagnosis only at birth. Recommendations for prenatal surveillance. Eur J Obstet Gynecol Reprod Biol. 139: 21—27. http://dx.doi.org/10.1016/j.ejogrb.2007.10.008; PMid:18068889

26. Towers CV, Carr MN. 2008. Antenatal fetal surveillance in pregnancies complicated by fetal gastroschisis. Am J Obstet Gynecol. 198: 686—695. http://dx.doi.org/10.1016/j.ajog.2008.03.024; PMid:18538153

27. Sadler TW. 2010. The embryologic origin of ventral body wall defects. Semin Pediatr Surg. 19: 209—214. http://dx.doi.org/10.1053/j.sempedsurg.2010.03.006; PMid:20610194

28. Sekabira J, Hadley GP. 2009. Gastroschisis: a third world perspective. Pediatr Surg Int. 25: 327—329. http://dx.doi.org/10.1007/s00383-009-2348-4; PMid:19288118

29. Wilson RD, Johnson MP. 2004. Congenital abdominal wall defects: an update. Fetal Diagnos Ther. 19: 385—398. http://dx.doi.org/10.1159/000078990; PMid:15305094