R. B. Kalish, S. T. Chasen, L. Rosenzweig, F. A. Chervenak
Esophageal atresia and tracheoesophageal fistula: the impact of prenatal
suspicion on neonatal outcome in a tertiary care center
Aims: To determine the impact of antenatal suspicion of
esophageal atresia (EA) with or without tracheoesophageal
fistula (TEF) on neonatal outcome.
Methods: Retrospective review of all neonates with EA
who received prenatal care including fetal ultrasound
and delivery at our institution from 1990–2001. Cases
with suspected EA on prenatal ultrasound (hydramnios
and/or an absent stomach bubble) were identified.
Neonatal outcome variables for the group suspected antenatally
and the group diagnosed postnatally were compared.
Mann Whitney U and Fischer exact tests were
used in analysis.
Results: Twenty-two patients met inclusion criteria.
Nine cases (40.9%) had prenatal ultrasound findings associated
with EA/TEF. There was no statistically significant
difference in the incidence of preterm delivery, intrauterine
growth restriction, respiratory distress syndrome,
additional anomalies or neonatal death, birth
weight, requirement for preoperative and postoperative
mechanical ventilation or length of hospital stay between
the prenatally suspected and postnatally diagnosed
groups. There were two neonatal demises: one had
trisomy 18 and one was born prematurely at 29 weeks.
Conclusions: In our experience, prenatal detection of ultrasound
findings associated with EA/TEF does not affect
neonatal outcome or identify a group at increased
risk for neonatal morbidity and mortality. Our favorable
outcomes, with or without prenatal suspicion, may reflect
the comprehensive care readily available at a tertiary
care facility. Larger series need to be studied to exclude
the possibility of a type II error.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 31, 03/2003
Pages: 111 - 114
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