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Review
. 2021 Nov 9;10(22):5215.
doi: 10.3390/jcm10225215.

Ultrasound Markers for Complex Gastroschisis: A Systematic Review and Meta-Analysis

Rui Gilberto Ferreira  1   2 , Carolina Rodrigues Mendonça  1 , Carolina Leão de Moraes  1 , Fernanda Sardinha de Abreu Tacon  1 , Lelia Luanne Gonçalves Ramos  3 , Natalia Cruz E Melo  4 , Lourenço Sbragia  5 , Waldemar Naves do Amaral  1 , Rodrigo Ruano  6
Affiliations
Review

Ultrasound Markers for Complex Gastroschisis: A Systematic Review and Meta-Analysis

Rui Gilberto Ferreira et al. J Clin Med. .

Abstract

Although gastroschisis is often diagnosed by prenatal ultrasound, there is still a gap in the literature about which prenatal ultrasound markers can predict complex gastroschisis. This systematic review and meta-analysis aimed to investigate the ultrasound markers that characterize complex gastroschisis. A systematic review of the literature was conducted according to the guidelines of PRISMA. The protocol was registered (PROSPERO ID CRD42020211685). Meta-analysis was displayed graphically on Forest plots, which estimate prevalence rates and risk ratios, with 95% confidence intervals, using STATA version 15.0. The combined prevalence of intestinal complications in fetuses with complex gastroschisis was 27.0%, with a higher prevalence of atresia (about 48%), followed by necrosis (about 25%). The prevalence of deaths in newborns with complex gastroschisis was 15.0%. The predictive ultrasound markers for complex gastroschisis were intraabdominal bowel dilatation (IABD) (RR 3.01, 95% CI 2.22 to 4.07; I2 = 15.7%), extra-abdominal bowel dilatation (EABD) (RR 1.55, 95% CI 1.01 to 2.39; I2 = 77.1%), and polyhydramnios (RR 3.81, 95% CI 2.09 to 6.95; I2 = 0.0%). This review identified that IABD, EABD, and polyhydramnios were considered predictive ultrasound markers for complex gastroschisis. However, evidence regarding gestational age at the time of diagnosis is needed.

Keywords: congenital anomalies; fetal intervention; fetal surgery; gastroschisis; prenatal diagnosis; ultrasound.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Assessment of the risk of bias.
Figure 3
Figure 3
Forest plot of the combined prevalence of atresia, necrosis, perforation, volvulus, and stenosis in fetal complex gastroschisis.
Figure 4
Figure 4
Forest plot of the prevalence of mortality in complex gastroschisis.
Figure 5
Figure 5
Forest plot of the prediction of complex gastroschisis with intraabdominal bowel dilatation (IABD), extra-abdominal bowel dilatation (EABD), and polyhydramnios.
Figure 6
Figure 6
Forest plot between simple and complex gastroschisis for IABD ultrasound markers.
Figure 7
Figure 7
Forest plot between simple and complex gastroschisis for EABD ultrasound markers.
Figure 8
Figure 8
Forest plot between simple and complex gastroschisis for polyhydramnios ultrasound markers.
See this image and copyright information in PMC

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