Can fetal magnetic resonance imaging aid prognosis in gastroschisis: A multicenter study

Objective To assess the contribution and impact of fetal magnetic resonance imaging (MRI) in managing fetal gastroschisis. Methods We conducted an observational retrospective study of gastroschisis patients at three fetal medicine centers from 2008 to 2019. The primary endpoint was the number of cases in which the MRI provided relevant information related to gastroschisis. Results A total of 189 patients were included, and our study group included 38 patients who underwent MRI. For the eight patients with suspected gastroschisis, MRI confirmed the diagnosis. In six cases, it provided additional relevant information (spiral turn, intestine ischemia, and bowel size discrepancy). For the 17 patients with ultrasound signs of additional gastrointestinal anomalies, MRI detected one case of unidentified complex gastroschisis on sonography. For the 13 patients undergoing routine MRI, no significant information was obtained. One termination of pregnancy and one fetoscopy were performed a few days after the MRI results. There was no subsequent follow‐up or additional bowel complications to support management. Conclusion Although MRI did not change the management of pregnancies complicated by fetal gastroschisis, patients presenting with fetal gastroschisis with intraabdominal bowel dilatation could benefit from MRI to allow for more precise prenatal counseling to predict postnatal intestinal complications before birth. Key points What's already known about this topic? The antenatal management of gastroschisis is based on ultrasonography and non‐stress testing. Intraabdominal bowel dilatation has been proposed as the main predictor of outcome for complex gastroschisis. Indications for MRI in gastroschisis are not well‐defined. What does this study add? Performing magnetic resonance imaging (MRI) did not modify the management of pregnancy in most cases. In more than 20% of cases (8/38), performing MRI could specify the anatomical injury complicating gastroschisis when associated with intraabdominal dilatation of the intestinal loops. It can help to refine the prenatal counseling and postnatal care protocols. MRI is only indicated in the third trimester in cases of complex gastroschisis.