Esophageal atresia and tracheoesophageal fistula: the impact of prenatal suspicion on neonatal outcome in a tertiary care center.
Academic Article
Overview
abstract
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.
