Prognostic significance of the pouch sign in fetuses with prenatally diagnosed esophageal atresia

Citation
Kd. Kalache et al., Prognostic significance of the pouch sign in fetuses with prenatally diagnosed esophageal atresia, AM J OBST G, 182(4), 2000, pp. 978-981
Citations number
12
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN journal
0002-9378 → ACNP
Volume
182
Issue
4
Year of publication
2000
Pages
978 - 981
Database
ISI
SICI code
0002-9378(200004)182:4<978:PSOTPS>2.0.ZU;2-F
Abstract
OBJECTIVE: Esophageal atresia may be diagnosed prenatally by ultrasonograph ic visualization of the blind-ending esophagus during fetal swallowing, whi ch is referred to as the pouch sign. Our purpose was to determine whether t his sign can be used to predict outcomes of affected fetuses. STUDY DESIGN: Four cases of esophageal atresia diagnosed in our center duri ng the past 2 years were analyzed, in conjunction with 3 cases from publish ed series. Ultrasonographic features of the pouch sign were categorized acc ording to localization. RESULTS: In the neck pouch group (n = 3) 1 fetus died in utero and 1 died b efore a corrective operation could be undertaken. In the only fetus of this group to survive a staged repair was necessary because of a long atretic g ap. Conversely, 3 of the 4 fetuses with a mediastinal pouch survived after a successful corrective operation, and primary repair was possible in all c ases. CONCLUSIONS: The base of the proximal blind-ending esophagus can be clearly localized by means of ultrasonography. Our data suggest that a neck pouch may be associated with an adverse outcome. This information may be useful i n counseling parents when esophageal atresia is diagnosed prenatally.