Prenatal diagnosis and perinatal outcomes in newborns with esophageal atresia

Introduction: Esophageal atresia is a rare congenital malformation of the digestive system. Early diagnosis is essential to plan adequate medical and surgical treatments. Objective: To evaluate the diagnosis of esophageal atresia using prenatal ultrasound and to describe the perinatal outcomes associated with this pathology. Methods: Descriptive, retrospective study of newborns with confirmed esophageal atresia seen at the Instituto Nacional Materno Perinatal (INMP) between 2019-2021. Data were collected on medical and ultrasound diagnoses, as well as maternal and neonatal variables. The procedures were approved by the institution's ethics committee. The information was kept confidential using alphanumeric codes, and a coded and restricted database was created for analysis. Results: There were 46,301 births at the INMP. Eighteen cases of confirmed esophageal atresia were identified (3.9 per 10,000 births). It was found that 66.7% of cases with esophageal atresia had some other associated malformation, cardiac being the most frequent. Intrauterine growth restriction (66.6%) and polyhydramnios (55.5%) were the most common findings in prenatal ultrasounds. Mortality was 50%, but only 20% when excluding fetuses with malformations. Conclusions: In neonates with confirmed esophageal atresia, intrauterine growth restriction was the most frequent ultrasound finding. Polyhydramnios and small or absent stomach were observed in about 50% of the cases, so their absence does not exclude the possibility of this pathology. The incidence of associated malformations was similar to that reported in other publications, but infant mortality was higher even after excluding malformed fetuses.