The effect of fetal urine on the development of thebowel in gastroschisis

Klück, P.; Tibboel, Dick; Kamp, A.W.M. van der; Molenaar, Jan C.

doi:10.1016/s0022-3468(83)80272-3

Cited by 80 publications

(50 citation statements)

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“…Amniotic fluid has been blamed for many of the abnormalities. [2][3][4]8,9,[11][12][13]16 secondary to direct action on the eviscerated loops for a large part of the pregnancy. [5][6][7][8][9][10][17][18][19][20] However, there are doubts about which component substances or substances might be responsible for the intestinal shortening, thickening and reduced peristalsis found in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][17][18][19][20] However, there are doubts about which component substances or substances might be responsible for the intestinal shortening, thickening and reduced peristalsis found in these patients. [1][2][3][4][11][12][13][14]21 Urine is the principal component of amniotic fluid, 5,9,[11][12][13]17 and, because of this, it has often been blamed for the intestinal damage, since the fetus physiologically urinates into the amniotic cavity. 5,9,[11][12][13]17,22,23 During the early 80s, in varying experiments, a number of different authors correlated urine with damage to the walls of herniated viscera.…”

Section: Discussionmentioning

confidence: 99%

“…However, in this type of experiment it is not possible to categorically determine whether only urine was responsible for the intestinal damage. 11,12 This has been the great difficulty of all of the experimental models tested to date; it is necessary to know which substance present in amniotic fluid could be responsible for the damage. In addition to the models referred to above, in which hens' eggs were used, other animal models have been investigated with bowel loops being subjected to exposure to human urine.…”

Section: Scorementioning

confidence: 99%

“…[2][3][4][5][6][7][8][9][10] Urine, the major component of this embryonic fluid compartment, has been blamed for damage to the intestinal wall by many authors. 5,9,[11][12][13] These observations are based on the physiological principal that all of the fetus' urine is excreted into the amniotic cavity.…”

Section: Introductionmentioning

confidence: 99%

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Reação inflamatória nas alças intestinais de ratos: pode a urina intraperitonial causar dano?

Ferreira¹,

Amantéa²,

Trindade³

et al. 2003

J. Pediatr. (Rio J.)

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Objective: To observe the intensity of the inflammatory reaction caused by urine on the intestinal wall of rats. Methods:Experimental model, using 20 Wistar rats divided into two groups. All the animals were submitted to abdominal puncture at the right inferior quadrant, twice daily for five days. In Group I (control group) no substance was inoculated during the procedure, while in Group II (urine group), 3 ml of neonatal urine were inoculated. The animals were killed on the sixth day. A small-bowel specimen was fixed in paraffin and stained with hematoxylin-eosin. Microscopic analysis was performed by the same pathologist in all cases for determination of the degree of inflammatory reaction in the intestinal wall.Results: All animals completed the experiment. In group I (control group) serositis was observed in six animals and enteritis in one. In group II (urine group) serositis was observed in nine animals and enteritis in four. The groups were similar in terms of the intensity of the inflammatory reaction observed (p = 0.1). Conclusion:The intra-abdominal inoculation of neonatal urine did not produce significant inflammatory reactions in the intestinal wall of rats.J Pediatr (Rio J). 2003;79(6):525-29: Gastrosquise, rats, intestine damage, urine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Scorementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reação inflamatória nas alças intestinais de ratos: pode a urina intraperitonial causar dano?

Ferreira¹,

Amantéa²,

Trindade³

et al. 2003

J. Pediatr. (Rio J.)

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“…Kluck et al [10] estimaient donc en 1983 que les composants urinaires étaient responsables des phénomènes inflammatoires. Il constate que les lésions débutent au jour 15 (terme = 21 ) et sont liées à une augmentation de la concentration amniotique en urée et en créatinine.…”

Section: Physiopathologie Des Lésions Digestivesunclassified

Gestion anténatale et issue postnatale des fœtus atteints de laparoschisis

Capelle

Schaaps

Foidart

2007

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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RésuméObjectifs. -Évaluer la pertinence et la qualité de la prise en charge du laparoschisis, pathologie malformative rare, dans un centre de référence de moyenne importance. Matériel et Méthode. -Étude rétrospective portant sur 24 cas de laparoschisis pris en charge au Centre hospitalier régional de la Citadelle, département de gynécologie et d'obstétrique de l'université de Liège, entre 1992 et 2003 en confrontant les données anténatales aux données pédiatriques. Résultats. -Vingt-quatre cas de laparoschisis ont été inclus. Le diagnostic prénatal a été posé dans 22 cas sur 24 à un âge gestationnel moyen de 23 semaines (92 %). Aucune anomalie du caryotype ou malformation associée n'a été décelée en anténatal. Trois enfants avec une communication interauriculaire sans répercussion fonctionnelle et un syndrome du X fragile ont été diagnostiqués en postnatal. Une interruption médicale de grossesse a été réalisée à 24 semaines et une mort foetale in utero est survenue à 35 semaines. Des lésions d'atrésie digestive de sténose ou d'ischémie sont présentes à la naissance chez huit enfants. Parmi les 22 enfants nés vivants, dix (45 %) ont pu bénéficier d'une cure chirurgicale primaire. Trois enfants sur 22 (14%) ont nécessité une réintégration en deux temps sans complication également. Neuf enfants sur 22 (41 %) ont subi des interventions multiples (deux à six). Ceux-ci ont tous présenté des complications postnatales, parfois systémiques, incluant trois décès, six enfants avec complications infectieuses, cinq avec complications digestives et deux avec complications rénales ou hématologiques. La durée d'hospitalisation varie de 19 à 378 jours (médiane = 51 jours). La durée du séjour hospitalier et le délai avant alimentation entérale totale sont allongés chez les enfants ayant présenté en prénatal un oligohydramnios ou des signes échographique de lésions digestives. Parmi les enfants nés avant 35 semaines, seuls ceux chez qui l'on constate à la naissance des lésions ischémiques digestives ont un séjour hospitalier et un délai avant alimentation entérale totale plus longs. Vingtdeux enfants sont nés vivants (92%) et 19 ont survécu (86%) après un an. Le taux de survie sans handicap corrélé au laparoschisis est de 84 %. Conclusion. -L'échographie est une méthode valide de diagnostic et de surveillance anténatale. Nos résultats sont en accord avec les bons taux de survie actuellement rapportés dans la littérature. Il faut cependant souligner la longueur du séjour hospitalier et la fréquence des complications postopératoires. Le pronostic est essentiellement conditionné par la sévérité des lésions digestives ischémiques constatées à la naissance pour lesquelles les possibilités de diagnostic et de prise en charge anténatale sont actuellement réduites. Mots clés : Laparoschisis ; Échographie obstétricale ; Résultats Abstract:Objectives. -To assess the relevance and the quality of gastroschisis's care in a mid level referral centre. Method. -A retrospective analysis was performed for infants diagnosed or born with gastroschisi...

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The natural history of gastroschisis during fetal life: Development of the fibrous coating on the bowel loops

Tibboel

Vermey-Keers

Klück³

et al. 1986

Teratology

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Patients with gastroschisis have a paraumbilical defect of the anterior abdominal wall through which bowel loops protrude. These bowel loops are edematous and covered by a fibrous coating. The moment of occurrence of gastroschisis as well as the development of the fibrous coating are unknown. This prompted an investigation of 26 human embryos and fetuses with gastroschisis at various developmental stages (crown-rump length 25-240 mm) and two stillborn fetuses (gestational age 30 weeks) with gastroschisis, as well as resected material from ten newborns (gestational age 33-40 weeks) operated for gastroschisis. Progressive changes of the serosa were only noted after the 30th week of gestation and consisted of an amniotic fluid peritonitis and progressive fibrosis. The changes are in agreement with experimental data and correlate with changes in the composition of amniotic fluid. The findings prove that gastroschisis is a very early occurrence, while the fibrous coating is a late development.

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The effect of fetal urine on the development of thebowel in gastroschisis

Cited by 80 publications

References 7 publications

Reação inflamatória nas alças intestinais de ratos: pode a urina intraperitonial causar dano?

Reação inflamatória nas alças intestinais de ratos: pode a urina intraperitonial causar dano?

Gestion anténatale et issue postnatale des fœtus atteints de laparoschisis

The natural history of gastroschisis during fetal life: Development of the fibrous coating on the bowel loops

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