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胎儿和新生儿结局在患有前腹壁缺陷(腹裂和脐膨出)的患者中。

Fetal and neonatal outcome in patients with anterior abdominal wall defects (gastroschisis and omphalocele).

机构信息

Department of Obstetrics and Gynecology, University of Saarland, Homburg/Saar, Germany.

出版信息

J Perinat Med. 2011 Nov 16;40(1):85-90. doi: 10.1515/JPM.2011.107.

Abstract

Fetuses with gastroschisis and omphalocele frequently show intrauterine growth restriction (IUGR). The aim of our study was to evaluate the intrauterine course of IUGR and the neonatal outcome in a large patient collective. We retrospectively included all euploid fetuses with gastroschisis and omphalocele between 2001 and 2009 in a single tertiary center. Patients' characteristics, serial ultrasound examinations and neonatal outcomes were evaluated. From 39 fetuses (28 gastroschisis, 11 omphalocele) 61.5% had IUGR <5th percentile and 15.4% had IUGR<10th percentile. The rate of IUGR did not differ significantly between the two groups during pregnancy. Newborns with gastroschisis showed an average weight of 2386 g, and those with omphalocele showed an average weight of 3148 g (P<0.001). Nevertheless, newborns with omphalocele were more frequently eutrophic than those with gastroschisis (88.8% vs. 52.2%, P=0.079). On average, only one surgical intervention was necessary for the definitive repair of the defect (65.5% of the newborns). Children with gastroschisis remained hospitalized nearly twice as long as children with an omphalocele (38 vs. 20 days). IUGR rates during pregnancy did not differ significantly between fetuses with gastroschisis and omphalocele although patients with defects of omphalocele were more frequently eutrophic at birth. Most newborns needed only one operation for definitive surgical treatment. The mean hospitalization time after this intervention was 4 weeks.

摘要

胎儿先天性腹壁畸形(腹裂和脐膨出)常伴有宫内生长受限(IUGR)。本研究旨在评估大型患者群体中 IUGR 的宫内进程和新生儿结局。我们回顾性纳入了 2001 年至 2009 年间单中心出生的所有染色体正常的腹裂和脐膨出胎儿。评估了患者的特征、连续超声检查和新生儿结局。在 39 例胎儿(28 例腹裂,11 例脐膨出)中,61.5%存在 IUGR<第 5 百分位数,15.4%存在 IUGR<第 10 百分位数。在整个妊娠期间,两组的 IUGR 发生率没有显著差异。腹裂新生儿的平均体重为 2386g,脐膨出新生儿的平均体重为 3148g(P<0.001)。然而,脐膨出新生儿比腹裂新生儿更常出现正氮平衡(88.8% vs. 52.2%,P=0.079)。平均而言,仅需一次手术即可完成缺陷的确定性修复(65.5%的新生儿)。患有腹裂的儿童住院时间几乎是患有脐膨出儿童的两倍(38 天 vs. 20 天)。尽管患有脐膨出缺陷的患者出生时更常出现正氮平衡,但腹裂和脐膨出胎儿的妊娠期间 IUGR 发生率没有显著差异。大多数新生儿仅需一次手术即可进行确定性手术治疗。干预后的平均住院时间为 4 周。

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