Dávila Romero Viviana, Aragón Mendoza Rafael L, Molina-Giraldo Saulo, Herrera Emiliano M, Leal Elman H, Gallo Roa Roberto, Rodríguez Ortiz Jorge A, Toro Angelica M, Peña Rafael R, Gómez Hoyos Diana, Nudelman Tammy, Vargas Fiallo Cristian L
Obstetrics and Gynecology Department, 27989 Universidad de La Sabana, Hospital Universitario de La Samaritana , Bogotá, Colombia.
Obstetrics and Gynecology Department, 150244 GINECOHUS Research Group, Hospital Universitario de la Samaritana , Bogotá, Colombia.
J Perinat Med. 2024 May 20;52(6):665-670. doi: 10.1515/jpm-2023-0520. Print 2024 Jul 26.
To identify factors associated with poor prognoses in newborns with a prenatal diagnosis of gastroschisis in eight hospitals in Bogota, Colombia, from 2011 to 2022.
A multi-center retrospective case-control study was conducted on newborns with gastroschisis in eight hospitals in Bogota, Colombia. Poor prognosis was defined as the presence of sepsis, intestinal complications, or death.
The study included 101 patients. Preterm newborns under 32 weeks had a poor neonatal prognosis (OR 6.78 95 % CI 0.75-319). Oligohydramnios (OR 4.95 95 % CI 1.15-21.32) and staged closure with silo (OR 3.48; 95 % CI 1.10-10.96) were risk factors for neonatal death, and intra-abdominal bowel dilation of 20-25 mm was a factor for the development of intestinal complications (OR 3.22 95 % CI 1.26-8.23).
Intra-abdominal bowel dilation between 20 and 25 mm was associated with intestinal complications, while oligohydramnios was associated with the risk of perinatal death, requiring increased antenatal surveillance of fetal wellbeing. Management with primary reduction when technically feasible is recommended in these infants, considering that the use of silos was associated with higher mortality.
确定2011年至2022年在哥伦比亚波哥大的八家医院中产前诊断为腹裂的新生儿预后不良的相关因素。
对哥伦比亚波哥大八家医院的腹裂新生儿进行了一项多中心回顾性病例对照研究。预后不良定义为存在败血症、肠道并发症或死亡。
该研究纳入了101例患者。孕周小于32周的早产儿新生儿预后不良（比值比6.78，95%置信区间0.75 - 319）。羊水过少（比值比4.95，95%置信区间1.15 - 21.32）和使用袋状缝合法分期关闭（比值比3.48；95%置信区间1.10 - 10.96）是新生儿死亡的危险因素，腹腔内肠管扩张20 - 25毫米是肠道并发症发生的一个因素（比值比3.22，95%置信区间1.26 - 8.23）。
腹腔内肠管扩张20至25毫米与肠道并发症相关，而羊水过少与围产期死亡风险相关，这需要加强对胎儿健康的产前监测。鉴于使用袋状缝合法与较高的死亡率相关，建议在技术可行时对这些婴儿进行一期复位处理。
