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Sarah J Melov, Irene Tsang, Ralph Cohen, Nadia Badawi, Karen Walker, Soundappan S V Soundappan, Thushari I Alahakoon
BACKGROUND: Gastroschisis is a congenital anomaly of the fetal abdominal wall, usually to the right side of umbilical insertion. It is often detected by routine antenatal ultrasound. Significant maternal and pediatric resources are utilised in the care of women and infants with gastroschisis. Increasing rates of gastroschisis worldwide have led institutions to review local data and investigate outcomes. A collaborative project was developed to review local epidemiology and investigate antenatal and neonatal factors influencing hospital length of stay (LOS) and total parental nutrition (TPN) in infants born with gastroschisis...
June 11, 2018: BMC Pregnancy and Childbirth
J Davies, J Parmar, I Finlay, J Day
Small bowel obstruction (SBO) is one of the most common causes for an acute surgical admission. Most of the time SBO is a result of common causes such as postoperative adhesions. However, rare and unusual causes of SBO do exist which can be challenging for surgeons. We report a first documented case of SBO caused by a remnant of the vas deferens in a 24-year-old patient with a history of gastroschisis and left orchidectomy. Clinical presentation, investigations, imaging and management of this case are described...
June 6, 2018: BMJ Case Reports
Martha M Werler, Esther Guéry, Dorothy K Waller, Samantha E Parker
BACKGROUND: Gastroschisis, a congenital defect of the abdominal wall, occurs disproportionately more in offspring of young mothers and has been increasing in prevalence over the past decades. A wide range of exposures have been reported in association with an increased gastroschisis risk, independent of mother's age; many have also been correlated with stress responses. METHODS: We explored cumulative exposures to such stressor exposures among 1,261 mothers of gastroschisis cases and 10,682 mothers of controls in the National Birth Defects Prevention Study (1997-2011)...
May 31, 2018: Epidemiology
Jessica Bannister, Lisa Szatkowski, Don Sharkey, Shin Tan, Linda Fiaschi, Lu Ban
OBJECTIVES: Survival in infants with gastroschisis is increasing although little is known about early childhood morbidity. In the context of a hypothesised link between the gastrointestinal (GI) tract and immune function, this study explores rates of GI and respiratory infections in children with gastroschisis. METHODS: We conducted a population-based retrospective cohort study using data from the Health Improvement Network (THIN), a large database of UK primary care medical records...
May 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
Shannon M Koehler, Matthew Loichinger, Erika Peterson, Melissa Christensen, Aniko Szabo, Amy J Wagner
OBJECTIVE: The aim of this study was to determine if meconium-stained amniotic fluid (MSAF) was associated with neonatal outcomes in gastroschisis. STUDY DESIGN: A retrospective chart review of gastroschisis patients from 2000 to 2014 at a single, tertiary institution was performed. Statistical analysis was performed with Fisher exact test, Welch's t-test, logistic regression and/or linear regression with significance at p < 0.05. RESULTS: Sixty-four of 135 (47...
April 27, 2018: Journal of Pediatric Surgery
Theerayuth Pratheeppanyapat, Kanokkan Tepmalai, Jesda Singhavejsakul, Jiraporn Khorana
BACKGROUND: Gastroschisis is the most common congenital abdominal wall defect. Due to the exposure of midgut to amniotic fluid, the recovery of bowel function is often delayed. This study aimed to identify the factors associated with the successful early enteral feeding in gastroschisis and to develop further guidelines of treatment. METHODS: A retrospective cohort study of gastroschisis babies from January 2006 to December 2015 was done. Exclusion criteria were incomplete data and death...
May 25, 2018: Pediatric Surgery International
Yuki Kojima, Katsusuke Ozawa, Rika Sugibayashi, Seiji Wada, Haruhiko Sago
The neonatal prognosis in gastroschisis is generally good; however, intrauterine fetal death (IUFD) and nonreassuring fetal status (NRFS) sometimes occur in fetal cases of gastroschisis. Previously, we reported stomach herniation as a possible risk factor for IUFD or NRFS in fetuses with gastroschisis. We report a case of fetal gastroschisis showing stomach herniation and increased velocity of the umbilical venous (UV) flow the day before NRFS by electronic fetal monitoring (EFM). A 27-year-old pregnant woman was followed up from 16 weeks' gestation due to fetal gastroschisis...
May 23, 2018: Journal of Obstetrics and Gynaecology Research
Ruchi Amin, Aaron Domack, Joseph Bartoletti, Erika Peterson, Britton Rink, Jennifer Bruggink, Melissa Christensen, Anthony Johnson, William Polzin, Amy J Wagner
BACKGROUND: Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. MATERIALS AND METHODS: An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan...
May 23, 2018: Fetal Diagnosis and Therapy
Michimasa Fujiogi, Nobuaki Michihata, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Jun Fujishiro
PURPOSE: The number of infants with gastroschisis is increasing worldwide, but advances in neonatal intensive care and parenteral nutrition have reduced gastroschisis mortality. Recent clinical data on gastroschisis are often from Western nations. This study aimed to examine clinical features and practice patterns of gastroschisis in Japan. METHODS: We examined treatment options, outcomes, and discharge status among inpatients with simple gastroschisis (SG) and complex gastroschisis (CG), 2010-2016, using a national inpatient database in Japan...
May 16, 2018: Pediatric Surgery International
Rita Caldas, Cátia Rodrigues, Carla Pina, Rosete Nogueira
Body-stalk anomaly is a sporadic and rare maldevelopment disorder characterised by large abdominal wall defect, spinal deformity and rudimentary umbilical cord. It is considered a lethal condition as there are only few reports of survival but there was at least one case of long-term survival after neonatal surgery.Differential diagnosis includes isolated omphalocele or gastroschisis, short umbilical cord, amniotic band, limb body-wall complex and other polymalformative syndromes.There are few reports about the expectant prenatal management of the body stalk anomaly as the majority of prenatal diagnosed cases undergo early elective termination...
May 12, 2018: BMJ Case Reports
Ester Garne, Anke Rissmann, Marie-Claude Addor, Ingeborg Barisic, Jorieke Bergman, Paula Braz, Clara Cavero-Carbonell, Elizabeth S Draper, Miriam Gatt, Martin Haeusler, Kari Klungsoyr, Jennifer J Kurinczuk, Nathalie Lelong, Karen Luyt, Catherine Lynch, Mary T O'Mahony, Olatz Mokoroa, Vera Nelen, Amanda J Neville, Anna Pierini, Hanitra Randrianaivo, Judith Rankin, Florence Rouget, Bruno Schaub, David Tucker, Christine Verellen-Dumoulin, Diana Wellesley, Awi Wiesel, Nataliia Zymak-Zakutnia, Monica Lanzoni, Joan K Morris
Septo-optic nerve dysplasia is a rare congenital anomaly with optic nerve hypoplasia, pituitary hormone deficiencies and midline developmental defects of the brain. The clinical findings are visual impairment, hypopituitarism and developmental delays. The aim of this study was to report prevalence, associated anomalies, maternal age and other epidemiological factors from a large European population based network of congenital anomaly registries (EUROCAT). Data from 29 full member registries for the years 2005-2014 were included, covering 6...
May 10, 2018: European Journal of Medical Genetics
Rachel Edwards, Jillian McCagg, Peter Chirico, Jennie Yoost
Gastroschisis is an abdominal wall defect through which the bowel herniates into the amniotic cavity. Surgical correction of gastroschisis is performed during infancy. Gynecologic concerns have not been described in this population as either an associated anomaly or complication of surgical repair. A 15 year old nulliparous female presented with abdominal pain with a history of gastrochisis requiring four surgeries in infancy. CT scan showed an ovary located in the RUQ which was concerning for torsion. She failed conservative management and was taken for a laparotomy with right oophorectomy...
May 3, 2018: Journal of Pediatric and Adolescent Gynecology
Boris Wittekindt, Rolf Schloesser, Nora Doberschuetz, Emilia Salzmann-Manrique, Jasmin Grossmann, Bjoern Misselwitz, Udo Rolle
INTRODUCTION:  Congenital malformations are associated with substantial neonatal morbidity and mortality. Furthermore, only sparse data are available on the modalities of care provided to and the associated clinical outcomes in affected neonates. In this study, we focused on five malformations that require surgery during the neonatal period: duodenal stenosis and atresia (DA), gastroschisis (GA), omphalocele (OM), congenital diaphragmatic herniation (CDH), and esophageal atresia (EA)...
May 1, 2018: European Journal of Pediatric Surgery
Federica Pederiva, Alberto Sgrò, Riccardo Coletta, Basem Khalil, Antonino Morabito
BACKGROUND: Short bowel syndrome (SBS) is the most common cause of intestinal failure in children. Many factors have been investigated in an attempt to define which parameters influence most survival and ability to wean off parenteral nutrition (PN). The aim of this study was to investigate if aetiology of SBS affects the outcomes in paediatric patients treated with autologous gastrointestinal reconstructive surgery. METHODS: All children with SBS who underwent autologous gastrointestinal reconstructive surgery between 2002 and 2012 were retrospectively reviewed and outcome measures were recorded...
March 12, 2018: Journal of Pediatric Surgery
Pablo Laje, Maria V Fraga, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N Scott Adzick
AIM OF THE STUDY: To evaluate the outcomes of neonates with complex gastroschisis (GC), and correlate outcomes with each type of complication. METHODS: Retrospective review of patients with complex GC owing to prenatal and/or postnatal abdominal complications; 2008-2016. Primary outcomes: time to discontinue parenteral nutrition (off-PN), length of stay (LOS) and neonatal survival. MAIN RESULTS: We treated 58 patients with complex gastroschisis owing to abdominal complications, which were: intestinal necrosis at birth (n=9), intestinal atresia (n=16), medical necrotizing enterocolitis (NEC) (n=15), surgical NEC (n=1), in utero volvulus (n=1), vanishing gastroschisis (n=2), severe intestinal dysmotility (n=1), delayed abdominal closure (n=3), abdominal compartment syndrome (n=2) and hiatal hernia/severe gastroesophageal reflux disease (GERD; n=11)...
March 14, 2018: Journal of Pediatric Surgery
R Colby Passaro, Kate B Savoie, Eunice Y Huang
BACKGROUND: This study examined clinical outcomes associated with the use of a gastroschisis-specific (GS) feeding advancement guideline. METHODS: We performed a retrospective study of all simple gastroschisis babies (N = 65) treated between June 2009June 2015. We compared patients treated on a postintestinal surgery guideline using either a 1-day (1D) or 3-day (3D) feeding advancement from August 2009-August 2013 with infants treated on a GS guideline from September 2013-June 2015...
April 4, 2018: Nutrition in Clinical Practice
B Frýbová, A Kokešová, R Vlk, M Rygl
INTRODUCTION: Gastroschisis is the most common malformation among abdominal wall defects with the incidence of 1:45000 live birth neonates. Postoperative care for these patients is very difficult due to the risk of abdominal compartment syndrome. The identification of markers that correlate with bowel damage in gastroschisis may prevent this serious postoperative complication. METHODS: Review of the literature. CONCLUSION: Prenatal ultrasound prediction of bowel damage followed by an appropriate surgical strategy is a possibility of optimizing care and outcomes in gastroschisis patients...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Adiam Y Woldemicael, Sarah Bradley, Caroline Pardy, Justin Richards, Paolo Trerotoli, Stefano Giuliani
INTRODUCTION:  Surgical site infection (SSI) is a key performance indicator to assess the quality of surgical care. Incidence and risk factors for SSI in neonatal surgery are lacking in the literature. AIM:  To define the incidence of SSI and possible risk factors in a tertiary neonatal surgery centre. MATERIALS AND METHODS:  This is a prospective cohort study of all the neonates who underwent abdominal and thoracic surgery between March 2012 and October 2016...
March 26, 2018: European Journal of Pediatric Surgery
Sandra F Centofanti, Rossana P V Francisco, Sonia T Phillippi, Inar A Castro, Mara S Hoshida, Rui Curi, Maria L Brizot
Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of abdominal organs. The underlying cause of the disease remains unknown; however, studies suggest that nutritional factors may play a role in its development. This prospective case-control study explored the association of serum fatty acid levels of pregnant women and occurrence of gastroschisis. Gastroschisis group comprised 57 pregnant women with fetuses with gastroschisis, and the control group comprised 114 pregnant women with normal fetuses...
April 2018: American Journal of Medical Genetics. Part A
Jose Duncan, Pranit Chotai, Anna Slagle, Ajay Talati, Eunice Huang, Mauro Schenone
PURPOSE: We aim to compare the mode of delivery in pregnancies with gastroschisis delivered in nonacademic institutions with those delivered in an academic center. MATERIAL AND METHODS: Chart review from 2008 to 2015 was performed. Cesarean delivery rate (CDR), attempted vaginal delivery rate (AVR), planned cesarean rate (PCR) and adverse neonatal outcomes were compared among pregnancies with gastroschisis delivered in nonacademic hospitals with those delivered in an academic institution...
March 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
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