Five year experience in prenatal ultrasound diagnosis of esophageal atresia in Saudi Arabia

Background: Esophageal atresia (EA), with or without tracheoesophageal fistula (TOF) is one of the most correctable fetal anomalies if diagnosed antenatally by serial ultrasound. We retrospectively evaluated antenatal diagnoses by ultrasound of EA with or without TOF at our institution in Saudi Arabia. Patients and Methods: We examined the records of mothers and infants with EA with or without TOF who were booked early and delivered at our institution during 1994 to 1998. Fetal diagnosis was based on level 11 serial ultrasound using a high-resolution ultrasound machine (n=78). Results: In the 5-year period, there were 58 491 live births, with 1345 congenital abnormalities (2.3%) and 78 cases of EA with or without TOF (0.13%) diagnosed antenatally. The survival rate was 68% for women with vaginal deliveries and 60% for women with caesarean deliveries, so caesarean delivery did not improve outcome. The Apgar score was 7 or greater at 5 minutes in 65 cases (83.5%), which emphasizes the problems such patients develop after delivery. Death was caused by anomalies other than EA that were incompatible with life, or in the post-operative period, by septicemia, renal failure or cot death. Conclusions: Our study suggests that early antenatal booking, serial ultrasound and early antenatal diagnosis improves outcome in EA with or without TOF.