Effect of amnioinfusion on the outcome of prenatally diagnosed gastroschisis

被引:67
作者
Luton, D [1 ]
de Lagausie, P [1 ]
Guibourdenche, J [1 ]
Oury, JF [1 ]
Sibony, O [1 ]
Vuillard, E [1 ]
Boissinot, C [1 ]
Aigrain, Y [1 ]
Beaufils, F [1 ]
Navarro, J [1 ]
Blot, P [1 ]
机构
[1] Hop Robert Debre, Dept Perinatol, F-75019 Paris, France
关键词
gastroschisis; inflammation; amnioinfusion; prenatal diagnosis;
D O I
10.1159/000020910
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
fusion 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. Objective: 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. Methods: 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 gastropediatric unit. Results: 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. Conclusion: 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.
引用
收藏
页码:152 / 155
页数:4
相关论文
共 14 条
[1]   AMNIO-ALLANTOIC FLUID EXCHANGE FOR THE PREVENTION OF INTESTINAL DAMAGE IN GASTROSCHISIS - AN EXPERIMENTAL-STUDY ON CHICK-EMBRYOS [J].
AKTUG, T ;
ERDAG, G ;
KARGI, A ;
AKGUR, FM ;
TIBBOEL, D .
JOURNAL OF PEDIATRIC SURGERY, 1995, 30 (03) :384-387
[2]  
DEBEUGNY P, 1986, CHIR PEDIATR, V27, P41
[3]   Serial transabdominal amnioinfusion in the management of gastroschisis with severe oligohydramnios [J].
Dommergues, M ;
Ansker, Y ;
Aubry, MC ;
Aleese, JM ;
LortatJacob, S ;
NihoulFekete, C ;
Dumez, Y .
JOURNAL OF PEDIATRIC SURGERY, 1996, 31 (09) :1297-1299
[4]   OUTCOME FOR FETUSES WITH ABDOMINAL-WALL DEFECTS DETECTED BY ROUTINE 2ND TRIMESTER ULTRASOUND [J].
EURENIUS, K ;
AXELSSON, O .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 1994, 73 (01) :25-29
[5]   FACTORS AFFECTING THE MEASUREMENT OF CYTOKINES IN BIOLOGICAL-FLUIDS - IMPLICATIONS FOR THEIR CLINICAL MEASUREMENT [J].
HENEY, D ;
WHICHER, JT .
ANNALS OF CLINICAL BIOCHEMISTRY, 1995, 32 :358-368
[6]  
LANGE JC, 1990, J PEDIATR SURG, V24, P992
[7]  
LANGER JC, 1993, OBSTET GYNECOL, V81, P53
[8]   ETIOLOGY OF INTESTINAL DAMAGE IN GASTROSCHISIS .2. TIMING AND REVERSIBILITY OF HISTOLOGICAL-CHANGES, MUCOSAL FUNCTION, AND CONTRACTILITY [J].
LANGER, JC ;
BELL, JG ;
CASTILLO, RO ;
CROMBLEHOLME, TM ;
LONGAKER, MT ;
DUNCAN, BW ;
BRADLEY, SM ;
FINKBEINER, WE ;
VERRIER, ED ;
HARRISON, MR .
JOURNAL OF PEDIATRIC SURGERY, 1990, 25 (11) :1122-1126
[9]   Prognostic factors of prenatally diagnosed gastroschisis [J].
Luton, D ;
DeLagausie, P ;
Guibourdenche, J ;
Oury, JF ;
Vuillard, E ;
Sibony, O ;
Farnoux, C ;
Aigrain, Y ;
Blot, P .
FETAL DIAGNOSIS AND THERAPY, 1997, 12 (01) :7-14
[10]   GASTROSCHISIS AND OMPHALOCELE [J].
MOLENAAR, JC ;
TIBBOEL, D .
WORLD JOURNAL OF SURGERY, 1993, 17 (03) :337-341