Accuracy of prenatal ultrasound in detecting jejunal and ileal atresia: a systematic review and meta-analysis

OBJECTIVE: The accuracy of prenatal ultrasound in detecting jejunal and ileal atresia has been reported in the literature to be extremely variable (25-90%). The aim of this systematic review was to evaluate the accuracy of prenatal ultrasound in detecting non-duodenal small bowel atresia (ND-SBA). METHODS: MEDLINE, EMBASE and The Cochrane Library including The Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and The Cochrane Central Register of Controlled Trials (CENTRAL) were searched electronically. The overall detection rate of ultrasound in detecting jejunal or ileal atresia was reported. The accuracy of polyhydramnios and dilated loops of bowel was also explored. RESULTS: 16 studies including 640 fetuses were included in this review. Detection rate of ultrasound in identifying ND-SBA was extremely variable, with values ranging from to 10 to 100% with an overall prediction of 50.63% (95% CI 38.0-63.2). When analysed separately, the detection rates of jejunal and ileal atresia were 66.30%, (95% CI 33.9-91.8) and 25.87% (95% CI 4.0-58.0) respectively. Both dilated bowel and polyhydramnios had an overall low detection rate for these anomalies. CONCLUSION: The diagnostic performance of ultrasound in identifying ND-SBA is extremely variable. Large studies are needed in order to identify objective and combined criteria to diagnose these anomalies.