¿Cuándo debe terminarse la gestación de una gastrosquisis?
Por:
Prat-Bartomeu J, Muñoz E, Calvo E, Sabria-Bach J, Miró E, Pertierra-Cortada A and Castañón M
Publicada:
20 abr 2017
Ahead of Print:
20 abr 2017
Categoría:
Medicine (miscellaneous)
Resumen:
OBJECTIVES: In gastroschisis pregnancies, a) to correlate prenatal ultrasound variables with postnatal outcome and b) to determine the ideal time for setting the delivery in order to achieve the best neonatal outcome. MATERIAL AND METHODS: Retrospective review (2000-2015) of all available gastroschisis whose prenatal findings could be correlated with the neonatal outcome. Two study groups have been defined according to the complications present after birth: favorable gastrosquisis and complicated. Prenatal variables were compared by groups using McWhitney or Chi tests as needed. RESULTS: Twenty-two gastroschisis fulfilled the requirement. Twelve cases had uneventful outcomes. Ten patients experienced complications, including death in five. In the complicated group there were 15 episodes of sepsis and 17 reoperations. Any single ultrasound parameter could predict a bad follow up. In thirteen cases, delivery was forced due to sudden changes on ultrasound bowel appearance. Nine of these patients had very good neonatal outcome. CONCLUSIONS: Finishing pregnancy when sudden changes on the fetal bowel were identified was the only strategy that leaded us to diminish the complication rate in gastroschisis.
Filiaciones:
Prat-Bartomeu J:
Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Muñoz E:
Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Calvo E:
Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Sabria-Bach J:
Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Miró E:
Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Pertierra-Cortada A:
Departamento de Neonatología. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Castañón M:
Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
Open Access
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