Gastroschisis and Omphalocele: Retrospective Study of Initial Postoperative Management in the ICU

Aizenfisz, Sophie; Dauger, Stéphane; Gondon, E.; Saizou, Carole; Luton, Dominique; Aigrain, Yves; Beaufils, F.

doi:10.1055/s-2006-924052

Cited by 8 publications

(13 citation statements)

References 16 publications

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“…In one report that included 9 neonates with GO (defined by a defect larger than 6 cm and/or liver herniation) managed with a staged-closure technique, the length of mechanical ventilation was notably short (median, 8 days) [4]. Tracheostomy use was reported in a few patients [2,11]. Most neonates with GO have abnormal chest radiographs (narrow chest width and small lung areas) [12], and preoperative functional residual capacity of the lungs was less than that of control values in newborns with omphalocele [13,14].…”

Section: Discussionmentioning

confidence: 99%

Neonatal care in patients with giant ompholocele: arduous management but favorable outcomes

Mitanchez

Walter-Nicolet

Humblot

et al. 2010

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Neonatal care in patients with giant ompholocele: arduous management but favorable outcomes

Mitanchez

Walter-Nicolet

Humblot

et al. 2010

Journal of Pediatric Surgery

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“…Even when the prenatal ruptured membrane of an omphalocele is believed to be rare [Bianchi et al, 2000; Chen, 2007], the abdominal contents will also be floating in the amniotic cavity, as in gastroschisis. Finally, in 15% of the cases the sac breaks during or immediately after delivery [Densler, 1982; Wilson and Johnson, 2004], and for the examining surgeon or pediatricians they become broken omphaloceles, which can also be easily misdiagnosed as gastroschisis [Aizenfisz et al, 2006]. Obviously, these perinatal complications are expected to occur more frequently in low resource areas of the world.…”

Section: Gastroschisis Among Body Wall Defectsmentioning

confidence: 99%

“…Irreversible damage of the eviscerated intestines might be preventable with transabdominal amniotic fluid exchange [Aktug et al, 1998], and reduced by monitoring of intestinal wall thickening to decide timing and way of delivery [Charlesworth et al, 2007; Murphy et al, 2007]. The postnatal benefits of prenatal diagnosis are clear and many, and include earlier family awareness, adequate institution of delivery with alerted obstetrical [Santiago‐Muñoz et al, 2007], pediatric, and surgical staff [Aizenfisz et al, 2006], better risk categorization, and personalized protocol for action.…”

Section: Public Health Impactmentioning

confidence: 99%

Gastroschisis: International epidemiology and public health perspectives

Castilla

Mastroiacovo

Orioli

2008

American J of Med Genetics Pt C

167

121

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Gastroschisis offers the intriguing epidemiological situation of a pandemic, strongly associated with very low maternal age. Identifying gastroschisis, and distinguishing it from the other abdominal wall defects, is theoretically easy but difficult in practice. The baseline birth prevalence of gastroschisis before the pandemic was approximately 1 in 50,000 births and has increased since between 10- and 20-fold. In many populations worldwide, it is still increasing. Such increasing prevalence and the association with very low maternal age are well proven, but the interaction between these two findings remains unknown. Geographic gradients (decreasing prevalence from North to South) are clear in Continental Europe and suggestive in Britain and Ireland. Gastroschisis seems more frequent in Caucasians compared to African Blacks and Orientals, and in Northern compared to Southern Europeans. These observations indicate the need for investigating gene-environment interactions. Since the global human situation is marked by inequalities among as well as within countries, the medical care and public health impact of gastroschisis varies widely among regions and social strata. The postnatal benefits of prenatal diagnosis of gastroschisis include family awareness; adequate planning of delivery with alerted obstetrical, pediatric, and surgical staff; optimal risk categorization, and personalized protocol for action. The increasing prevalence of gastroschisis combined with improved medical techniques to reduce morbidity and mortality are also increasing the burden and costs of this anomaly on health systems.

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“…The congenital heart defects of these chromosomal anomalies tend to present with hemodynamic compromise [25,28,38]. The establishment of regional and national databases for omphalocele would enhance the statistical understanding of the true incidence of congenital heart defects and hemodynamic compromise in omphalocele infants as few detailed reports with large sample size exist.…”

Section: Congenital Heart Defectsmentioning

confidence: 99%

Respiratory management of the newborn with an omphalocele

Baerg¹

2017

J Pulm Respir Med

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Despite advances in neonatal care, infants with omphalocele have a mortality rate ranging between % and %. Respiratory insufficiency is a common clinical challenge and an independent predictor of mortality in these infants. The causes of respiratory failure are diverse and are not well understood. This chapter discusses the unique aspects of respiratory management in omphalocele infants. The authors have chosen references in this chapter with appropriate sample size, variable comparisons, regression analyses, and documented median follow-up times. Omphalocele is rare therefore, the case reports of chapter references have important information.Omphalocele infants are sometimes born with inadequate lung volume to support survival. Prenatal predictors of pulmonary hypoplasia are discussed in the context of fetal magnetic resonance imaging MRI and postnatal clinical-radiologic correlation studies. Two recent retrospective articles explain the unique aspects of pulmonary hypertension in omphalocele infants and distinguish it from pulmonary hypoplasia. The avoidance of abdominal compartment syndrome at the time of omphalocele closure is discussed. Clinical strategies that improve the respiratory care of these infants, based on Specific definitions and diagnoses, may reduce the high mortality rate.

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Gastroschisis and Omphalocele: Retrospective Study of Initial Postoperative Management in the ICU

Abstract: Haemodynamic instability can be expected in patients with G or RO, and ventilatory requirements were higher in infants with O than in infants with G during the first week after surgery.

Cited by 8 publications

References 16 publications

Neonatal care in patients with giant ompholocele: arduous management but favorable outcomes

Neonatal care in patients with giant ompholocele: arduous management but favorable outcomes

Gastroschisis: International epidemiology and public health perspectives

Respiratory management of the newborn with an omphalocele

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