The Fetal Stomach Throughout Gestation: Normal Charts And Clinical Implication

Objectives To construct a nomogram of fetal stomach, and to prospectively determine the clinical value of stomach measurement in pathological cases.Methods A cross-sectional prospective study was conducted between 14 and 40 weeks in well-dated, low-risk, singleton pregnancies. Stomach dimensions were acquired in longitudinal plane in which maximal stomach length was measured, and in axial plane in which were measured: antero-posterior and latero-lateral. Stomach maximal and axial 1st to 99th centiles were calculated for each gestational-week.Results Five hundred fifty-four measurements were performed. A cubic polynomial regression model best described the correlation between stomach size and gestational age. The correlation coefficient (r(2)) was 0.627 and 0.754 (p < 0.001) for the stomach axial and maximal diameters, respectively. Intra- and interobserver variability had high interclass correlation coefficients (>0.9). Nomograms were created for predicted stomach axial and maximal 1st, 3rd, 10th, 25th, 50th,75th, 90th, 95th, 97th, and 99th centiles. The nomogram correctly detected 92.3% (12/13) of pathological cases including three bowel obstruction, eight esophageal atresia, and two hypotonic syndromes.Conclusions The present study provides updated nomograms of the fetal stomach. Clinical application of these nomograms may assist in preventing unnecessary investigation in falsely perceived small or large stomachs and may improve the in utero detection of true pathologies.