It Is Complex: Predicting Gastroschisis Outcomes Using Prenatal Imaging

Background Gastroschisis occurs in one of 2000 births with survival rates partially contingent on intestinal complications and time to establishing feeding. Enhancements prenatal imaging have given better insight into postnatal outcomes. The goal this study was examine the gastroschisis patient population at a single children's hospital modern era use ultrasound (US) develop new prognostic indicators. Methods We performed retrospective review patients quaternary-care referral from 2010 through 2018. recorded demographics, data imaging, early data, operative compared within our cohort born complex (bowel atresia/perforation) uncomplicated patients. Second trimester third US were evaluated for changes amniotic fluid level, amount external bowel, bowel dilatation, wall edema identify indicators status birth. For categorical variables, chi-square tests used assess significance. Univariate multivariable analyses significance between continuous variables using medians interquartile ranges or means. Results A total 134 included study: (n = 24), 110). Compared gastroschisis, required longer median days feeding initiation (44 versus 10; P < 0.001), full (80 23; length stay (83 33; parenteral nutrition discharge (P 0.004). Full available 81% patients, partial identified 19%. Prenatal analysis showed significantly more had polyhydramnios (23.5%-4.3%; 0.018). these additional factors be most associated gastroschisis: large US, increase dilation US. Multivariable logistic regression revealed significant predictor 0.01). Polyhydramnios combination two-thirds other both sensitivity positive predictive value predicting 75%. Patients two less high specificity (96.8%) negative (87.5%), suggesting disease. There no differences perioperative long-term group when gastroschisis. Conclusions babies can predict birth, whereas absence markers suggest Complex is increased feeds stay.