Superior mesenteric artery Doppler velocimetry and ultrasonographic assessment of fetal bowel in gastroschisis: a prospective longitudinal study

American Journal of Obstetrics and Gynecology
A Z AbuhamadA T Evans

Abstract

Our purpose was to determine whether Doppler velocimetry of the superior mesenteric artery and its mesenteric branches and ultrasonographic assessment of bowel can predict postnatal outcome in fetuses with gastroschisis. The normal reference range for the superior mesenteric artery pulsatility index was determined by studying 161 normal fetuses. Over a 24-month period superior mesenteric artery pulsatility index, superior mesenteric artery mesenteric branches systolic/diastolic ratio, bowel diameter, and bowel wall thickness were prospectively and longitudinally obtained from 17 fetuses with gastroschisis. Poor neonatal outcome was defined by bowel resection or staged repair of the defect or a hospital stay > 50 days. Doppler velocimetry of the superior mesenteric artery and its mesenteric branches proved minimally useful in prognosticating neonatal outcome. No difference was found in the superior mesenteric artery pulsatility index between the good and poor neonatal outcome groups (p = 0.99). Longitudinal data analysis on all fetuses with gastroschisis showed an increase in bowel diameter with advancing gestation (p < 0.0001). A greater rate of increase in bowel diameter with advancing gestation was noted in the poor-neonatal-...Continue Reading

References

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