Prat J, Muñoz E, Calvo E, Sabrià J, Miró E, Pertierra A, Castañón M
Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona.
Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona.
Cir Pediatr. 2017 Apr 20;30(2):89-94.
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.
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.
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.
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.
在腹裂妊娠中，a）将产前超声变量与产后结局相关联，b）确定理想的分娩时间以实现最佳的新生儿结局。
回顾性分析（2000 - 2015年）所有产前检查结果可与新生儿结局相关联的腹裂病例。根据出生后出现的并发症定义了两个研究组：预后良好的腹裂和复杂腹裂。根据需要使用McWhitney或卡方检验对两组的产前变量进行比较。
22例腹裂病例符合要求。12例结局良好。10例患者出现并发症，其中5例死亡。在复杂组中有15次败血症发作和17次再次手术。任何单一超声参数都无法预测不良预后。13例因超声显示肠管外观突然改变而被迫分娩。其中9例患者的新生儿结局非常好。
当发现胎儿肠管有突然变化时结束妊娠是唯一能使我们降低腹裂并发症发生率的策略。
