Luton D, de Lagausie P, Guibourdenche J, Oury J, Sibony O, Vuillard E, Boissinot C, Aigrain Y, Beaufils F, Navarro J, Blot P
Département de périnatalogie, Hôpital Robert-Debré, Paris, France.
Fetal Diagn Ther. 1999 May-Jun;14(3):152-5. doi: 10.1159/000020910.
Following recent data showing that an inflammatory response exists in the amniotic fluid of gastroschisis-affected fetuses, we hypothesized that amniotic fluid exchange or amnioinfusion would improve the prognosis of prenatally diagnosed gastroschisis.
We compared the outcome of prenatally amnioinfused fetuses with gastroschisis to non-amnioinfused fetuses with gastroschisis. 10 patients undergoing this procedure were matched with 10 patients of our previous study. Comparisons were done on data including surgical procedure, follow-up in the NICU and the gastro-pediatric unit.
Our results show that gastroschisis-affected fetuses undergoing amnioinfusion had a lower duration of curarization after surgery (2.2 +/- 1.9 vs. 6.8 +/- 6.9 days, p = 0.019), a shorter delay before full oral feeding (49.7 +/- 21.5 vs. 72.3 +/- 56.6 days, NS), and a shorter overall length of hospitalization (59.5 +/- 19.7 vs. 88.5 +/- 73.6 days, NS). We confirmed our previous data showing that amniotic fluid displays a chronic inflammation profile.
Our data suggest that amnioinfusion could improve the outcome of gastroschisis affected fetuses. The hypothesis by which this improvement could be due to a reduction of an inflammatory response remains to be proved.
近期数据显示，患有腹裂的胎儿羊水中存在炎症反应，我们据此推测羊水置换或羊膜腔灌注可改善产前诊断为腹裂的胎儿的预后。
我们将产前接受羊膜腔灌注的腹裂胎儿的结局与未接受羊膜腔灌注的腹裂胎儿进行了比较。10名接受该手术的患者与我们之前研究中的10名患者进行了匹配。对包括手术过程、新生儿重症监护病房（NICU）和胃肠儿科病房的随访数据进行了比较。
我们的结果表明，接受羊膜腔灌注的腹裂胎儿术后箭毒化持续时间较短（2.2±1.9天对6.8±6.9天，p = 0.019），完全经口喂养前的延迟时间较短（49.7±21.5天对72.3±56.6天，无统计学意义），总体住院时间较短（59.5±19.7天对88.5±73.6天，无统计学意义）。我们证实了之前的数据，即羊水呈现慢性炎症特征。
我们的数据表明，羊膜腔灌注可改善腹裂胎儿的结局。这种改善可能是由于炎症反应减轻这一假说仍有待证实。
