Childhood Educational Outcomes of Children Born with Gastroschisis
To compare third grade literacy and mathematics test proficiency among children born with gastroschisis vs. unaffected controls and identify predictors of academic proficiency among these children.
Conclusion Although reasons, such as induced preterm delivery of fetuses with certain anomalies, could partially account for their high prematurity rates, susceptibility to preterm birth might exist through underlying mechanisms related with the defects. The identification of BDs associated with prematurity should serve to improve measures that prevent preterm birth especially of fetuses at risk. Key Points [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text
Gastroschisis is a congenital abdominal wall defect where bowel is directly exposed to amniotic fluid during gestation, causing irritation and leading to shortening, twisting, or swelling. While the etiology remains unknown, there are likely both genetic and environmental factors that influence the incidence of gastroschisis . This defect is estimated by the Centers for Disease Control and Prevention to occur in 1,871 babies in the United States annually  or approximately every 1 in 2,000 births .
Standardized protocols have been shown to improve outcomes in several pediatric surgical conditions. We implemented a multi-disciplinary gastroschisis practice bundle at our institution in 2013. We sought to evaluate its impact on closure type and early clinical outcomes.
Objectives: Define clinical spectrum and long-term outcomes of gut malrotation. With new insights, an innovative procedure was introduced and predictive models were established. Methods: Over 30-years, 500 patients were managed at 2 institutions. Of these, 274 (55%) were children at time of diagnosis. At referral, 204 (41%) patients suffered midgut-loss and the remaining 296 (59%) had intact gut with a wide range of digestive symptoms. With midgut-loss, 189 (93%) patients underwent surgery with gut transplantation in 174 (92%) including 16 of 31 (16%) who had autologous gut reconstruction. Ladd's procedure was d...
This article is protected by copyright. All rights reserved.PMID:34468062 | DOI:10.1002/uog.24759
ConclusionFetal MRI predicted silo bag treatment in patients with gastroschisis in 90% of the cases in our cohort and might facilitate prenatal counseling and treatment planning.
Discussion Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in neonates. Mortality rates are from 0-45% depending on infant weight and gestation with more premature and smaller infants having greater mortality. NEC usually occurs in premature infants but it also occurs in term infants. The etiology is unknown but is probably multifactorial with ischemia and/or reperfusion playing some role. There are ‘outbreaks’ of NEC but no causative organism has been identified. Regardless of the originating cause, inflammation of the intestine and release of inflammatory mediators cause...
AbstractStudy questionIs in utero exposure to five over-the-counter (non-prescription) analgesics (paracetamol, ibuprofen, aspirin, diclofenac, naproxen) associated with offspring health outcomes?Summary answerConsumption of over-the-counter analgesics during pregnancy, either as single compounds or in combinations, is significantly associated with a variety of adverse offspring health outcomes.What is known alreadyA high percentage of pregnant women use over-the-counter analgesics during pregnancy globally. Some of these compounds such as paracetamol are considered safe to use, while contraindications exist for others, su...
Cryptorchidism associated with gastroschisis has been poorly investigated. We aimed to assess the prevalence of this association, and to address the management and outcome of cryptorchidism in this context.
Wide practice variation exists in the management of gastroschisis. Reduction of the eviscerated bowel and closure of the gastroschisis defect was traditionally performed in the operating room. In recent years, however, many surgeons have chosen to perform reduction and closure at the bedside in the neonatal intensive care unit (NICU) [1-3]. Some surgeons attempt to close all gastroschises primarily, while others routinely perform staged closure using a silo [4,5]. Primary closure may be performed either by suturing the closed defect or by performing a “sutureless closure” using the umbilical cord as a flap [1,6-9].