Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape
Objective We investigated prenatal sonographic characteristics of esophageal atresia (EA) with advancing gestation. We focused on the degree of polyhydramnios and the stomach shape. Methods This study included 27 EA cases (EA group) and 81 idiopathic polyhydramnios cases (non-EA group). The non-EA g...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Obstetrics and Gynecology
2021-01-01
|
| Series: | Obstetrics & Gynecology Science |
| Subjects: | |
| Online Access: | http://www.ogscience.org/upload/pdf/ogs-20207.pdf |
| _version_ | 1818956426557521920 |
|---|---|
| author | Chi-Son Chang Yunsun Choi Seo-yeon Kim Cheonga Yee Mina Kim Ji-Hee Sung Sanghoon Lee Suk-Joo Choi Soo-young Oh Jeong-Meen Seo Cheong-Rae Roh |
| author_facet | Chi-Son Chang Yunsun Choi Seo-yeon Kim Cheonga Yee Mina Kim Ji-Hee Sung Sanghoon Lee Suk-Joo Choi Soo-young Oh Jeong-Meen Seo Cheong-Rae Roh |
| author_sort | Chi-Son Chang |
| collection | DOAJ |
| description | Objective We investigated prenatal sonographic characteristics of esophageal atresia (EA) with advancing gestation. We focused on the degree of polyhydramnios and the stomach shape. Methods This study included 27 EA cases (EA group) and 81 idiopathic polyhydramnios cases (non-EA group). The non-EA group consisted of cases without any fetal structural anomaly, musculoskeletal disorder, chromosomal abnormality, or maternal diabetes. Both groups included only singleton pregnancies. Amniotic fluid index (AFI) and width/length (W/L) ratio as well as the product of width and length (W×L) of stomach were serially assessed during gestation and compared between the 2 groups. To predict EA using W/L ratio and W×L, receiver operating characteristic curve analysis was performed. Results Polyhydramnios was evident in 77.8% of EA cases. We observed 25.9% and 22.2% EA cases with an absent stomach and a small visible stomach, respectively. After 28 weeks, the EA group manifested significantly higher AFI than the non-EA group. After 32 weeks, W/L ratio in the EA group tended to be lower than that in the non-EA group (32–36 weeks: 1.36 vs. 1.72, P=0.092; >36 weeks: 1.43 vs. 1.63, P=0.024). To predict EA, the calculated area under the curve for W/L ratio was 0.651 after 32 weeks. The diagnosis of EA using a cut-off value of W/L ratio <1.376 showed sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio to be 84.6%, 52.9%, 1.796, and 0.081, respectively. Conclusion A low W/L ratio of stomach after 32 weeks with progressive idiopathic polyhydramnios may be used to predict EA. |
| first_indexed | 2024-12-20T10:53:46Z |
| format | Article |
| id | doaj.art-e755d58f3c9b431e88b99dc68f740e1f |
| institution | Directory Open Access Journal |
| issn | 2287-8572 2287-8580 |
| language | English |
| last_indexed | 2024-12-20T10:53:46Z |
| publishDate | 2021-01-01 |
| publisher | Korean Society of Obstetrics and Gynecology |
| record_format | Article |
| series | Obstetrics & Gynecology Science |
| spelling | doaj.art-e755d58f3c9b431e88b99dc68f740e1f2022-12-21T19:43:11ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85722287-85802021-01-01641425110.5468/ogs.202078599Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shapeChi-Son Chang0Yunsun Choi1Seo-yeon Kim2Cheonga Yee3Mina Kim4Ji-Hee Sung5Sanghoon Lee6Suk-Joo Choi7Soo-young Oh8Jeong-Meen Seo9Cheong-Rae Roh10 Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaObjective We investigated prenatal sonographic characteristics of esophageal atresia (EA) with advancing gestation. We focused on the degree of polyhydramnios and the stomach shape. Methods This study included 27 EA cases (EA group) and 81 idiopathic polyhydramnios cases (non-EA group). The non-EA group consisted of cases without any fetal structural anomaly, musculoskeletal disorder, chromosomal abnormality, or maternal diabetes. Both groups included only singleton pregnancies. Amniotic fluid index (AFI) and width/length (W/L) ratio as well as the product of width and length (W×L) of stomach were serially assessed during gestation and compared between the 2 groups. To predict EA using W/L ratio and W×L, receiver operating characteristic curve analysis was performed. Results Polyhydramnios was evident in 77.8% of EA cases. We observed 25.9% and 22.2% EA cases with an absent stomach and a small visible stomach, respectively. After 28 weeks, the EA group manifested significantly higher AFI than the non-EA group. After 32 weeks, W/L ratio in the EA group tended to be lower than that in the non-EA group (32–36 weeks: 1.36 vs. 1.72, P=0.092; >36 weeks: 1.43 vs. 1.63, P=0.024). To predict EA, the calculated area under the curve for W/L ratio was 0.651 after 32 weeks. The diagnosis of EA using a cut-off value of W/L ratio <1.376 showed sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio to be 84.6%, 52.9%, 1.796, and 0.081, respectively. Conclusion A low W/L ratio of stomach after 32 weeks with progressive idiopathic polyhydramnios may be used to predict EA.http://www.ogscience.org/upload/pdf/ogs-20207.pdfesophageal atresiastomach shapepolyhydramniosultrasoundprenatal diagnosis |
| spellingShingle | Chi-Son Chang Yunsun Choi Seo-yeon Kim Cheonga Yee Mina Kim Ji-Hee Sung Sanghoon Lee Suk-Joo Choi Soo-young Oh Jeong-Meen Seo Cheong-Rae Roh Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape Obstetrics & Gynecology Science esophageal atresia stomach shape polyhydramnios ultrasound prenatal diagnosis |
| title | Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape |
| title_full | Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape |
| title_fullStr | Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape |
| title_full_unstemmed | Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape |
| title_short | Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape |
| title_sort | prenatal ultrasonographic findings of esophageal atresia potential diagnostic role of the stomach shape |
| topic | esophageal atresia stomach shape polyhydramnios ultrasound prenatal diagnosis |
| url | http://www.ogscience.org/upload/pdf/ogs-20207.pdf |
| work_keys_str_mv | AT chisonchang prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT yunsunchoi prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT seoyeonkim prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT cheongayee prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT minakim prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT jiheesung prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT sanghoonlee prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT sukjoochoi prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT sooyoungoh prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT jeongmeenseo prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape AT cheongraeroh prenatalultrasonographicfindingsofesophagealatresiapotentialdiagnosticroleofthestomachshape |