Congenital duodenal obstruction: The impact of an antenatal diagnosis

Hancock, B.J.; Wiseman, Nathan E.

doi:10.1016/s0022-3468(89)80208-8

Cited by 32 publications

(43 citation statements)

References 17 publications

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“…These findings are consistent with two other series documenting postnatal diagnosis in 56% of cases of congenital duodenal obstruction. 10,11 Although these reports did not provide details of neonatal condition, one indicated that diagnosis occurred at a mean of 5.7 days of life; later diagnosis was associated with delayed surgery and longer hospital stay. 11 In our report, infants whose defect was diagnosed prenatally had earlier surgery than those diagnosed postnatally; however, there was no difference in length of hospitalization, probably because those diagnosed antenatally were less mature and more likely to have other birth defects compared with the postnatal diagnosis group.…”

Section: Congenital Duodenal Obstruction H Kilbride Et Almentioning

confidence: 99%

Congenital duodenal obstruction: timing of diagnosis during the newborn period

2009

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Objective: To determine age at diagnosis for congenital duodenal obstruction in the neonatal period and the relationship to clinical outcomes.Study Design: A children's hospital database reflecting a 7 ½-year period was reviewed to identify infants with the diagnosis of duodenal obstruction in the neonatal period. Infants were grouped according to time of diagnosis: antepartum, postpartum in-hospital or after hospital discharge. Clinical descriptors and outcome variables were assessed between infants in these three groups.Result: In total, 27/51 (53%) infants were diagnosed antenatally. Infants with prenatal diagnosis were less mature, more likely to have Down syndrome or other birth defects and the pregnancy was more likely to be complicated by polyhydramnios. Of the 24 infants diagnosed postnatally, 8 (33%) were diagnosed after hospital discharge. These infants tended to be breast fed and discharged before 48 h of age. They had greater weight loss and more metabolic disturbances at readmission for surgery. One infant in the late diagnosis group died.Conclusion: Infants with congenital duodenal obstruction, particularly if breast fed, may not present with classical findings of upper gastrointestinal obstruction in the first days of life. Careful in-hospital evaluation of infants with persistent regurgitation, even low volume, is recommended to avoid missing this diagnosis.

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Section: Congenital Duodenal Obstruction H Kilbride Et Almentioning

confidence: 99%

Congenital duodenal obstruction: timing of diagnosis during the newborn period

2009

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“…Duodenal obstruction (DO) is a congenital abnormality that occurs in around 1.3 per 10 000 live births1, 2; it is the most commonly detected small‐bowel obstruction during fetal life3. In approximately half of cases it is associated with other abnormalities, particularly cardiac, vertebral, renal and gastrointestinal ones such as anal atresia and tracheoesophageal atresia (non‐isolated DO)4, 5. DO is associated with trisomy 21 in 30% of cases5.…”

Section: Introductionmentioning

confidence: 99%

Solution Structure of Quinoline‐ and Pyridine‐Derived Oligoamide Foldamers

Dolain¹,

Grélard²,

Laguerre³

et al. 2005

Chemistry A European J

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The unambiguous elucidation of a new folded structure in solution may prove to be a very challenging task. The NMR protocols developed for solving the solution structures of alpha-peptides have been applied to aliphatic beta- and gamma-peptides but are not directly applicable to aromatic oligomers. In particular, the string of spin systems in an aromatic sequence cannot be reconstituted solely from correlations between protons. For aromatic oligomers, it is shown that the assignment of a large part of the 13C NMR spectrum through HMBC and HSQC experiments allows to unambiguously assign proton NMR spectra and in turn to interpret NOE correlations. This has been implemented both with quinoline- and pyridine-derived oligoamide foldamers, and should be applicable to a wide range of oligomers including various combinations of monomers. The NOE correlations allow the unambiguous solution structure elucidation of helical conformations of oligoamides derived from pyridine and quinoline monomers showing that, in these series, the solution structures correspond very well to the structures observed in the solid state.

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“…Hydramnios is frequently found among these patients (77% in our series), but is missing in some cases because of a possible placental balancing, still unexplained [4,[10][11][12] . Prenatal recognition of incomplete CDO, either intrinsic or secondary to extrinsic compression, is rather unusual.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for an infrequent earlier detection in utero of the typical double-bubble feature of CDO are still not clear; it is probably the result of an initial low-pressure gastric emptying which is not able to distend the proximal duodenum until later in gestation. Furthermore, foetal vomiting may decompress the stomach so that the double-bubble sign may be missed on a single scan [12] . There are obvious benefits from a PND of CDO.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Duodenal Obstruction Selects Cases with a Higher Risk of Maternal-Foetal Complications and Demands in utero Transfer to a Tertiary Centre

et al. 2008

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Objectives: It was the aim of this study to determine if prenatal diagnosis of congenital duodenal obstruction (CDO) selects high-risk pregnancies and demands special perinatal attention. Methods: Medical records of 62 neonates with intrinsic CDO, admitted since 1981 in 2 institutions, were reviewed and divided into 2 groups: 39 cases, detected in utero by a prenatal ultrasonogram (group A), and 23 diagnosed at birth (group B). Prevalence of complete CDO, mean gestational age, mean birth weight, hydramnios, as well as maternal-foetal complications requiring emergency Caesarean section and associated with premature delivery were compared in the 2 groups. Results: A complete CDO was found in 77% of patients in group A versus 48% of patients in group B (p < 0.02). Differences in mean gestational age and mean birth weight in the 2 groups were non-significant. Prenatally diagnosed patients presented a higher prevalence of hydramnios, maternal-foetal complications and premature delivery. Conclusions: Prenatal diagnosis selects patients with complete CDO and hydramnios. These pregnancies present a high incidence of maternal-foetal complications, which may require an emergency Caesarean section, and are frequently associated with premature delivery. These aspects must be considered in prenatal counselling. In utero transfer to a tertiary centre for delivery and appropriate perinatal care should be recommended.

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Congenital duodenal obstruction: The impact of an antenatal diagnosis

Cited by 32 publications

References 17 publications

Congenital duodenal obstruction: timing of diagnosis during the newborn period

Congenital duodenal obstruction: timing of diagnosis during the newborn period

Solution Structure of Quinoline‐ and Pyridine‐Derived Oligoamide Foldamers

Prenatal Diagnosis of Duodenal Obstruction Selects Cases with a Higher Risk of Maternal-Foetal Complications and Demands in utero Transfer to a Tertiary Centre

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