Antenatal diagnosis and perinatal care of anterior abdominal wall defects
Karamanoukian, Hratch L; O'Toole, Stuart J; Glick, Philip L; Karamanoukian Hratch L; Buffalo Institute of Fetal Therapy (BIFT); O'Toole Stuart J; Buffalo Institute of Fetal Therapy (BIFT); Glick Philip L; Buffalo Institute of Fetal Therapy (BIFT); Buffalo Institute of Fetal Therapy (BIFT)
Журнал:
Fetal and Maternal Medicine Review
Дата:
1995
Аннотация:
Improvements in anaesthetic care and postoperative management over the last two decades have significantly improved survival of neonates with ventral abdominal wall defects, from a dismal 47% in 1971, to 96% for both gastroschisis and isolated omphalocele in two recent series. This increased survival has generally been attributed to result from improvements in the pre and postoperative management of these fragile neonates. Specifically, the routine use of total parenteral nutrition, and staged repairs for cases with severe “viscero-abdominal disproportion” have been implicated in a decreased incidence of sepsis, morbidity and mortality. In addition, an appreciation of the wide spectrum of anomalies uniquely associated with gastroschisis and omphalocele have helped improve survival, as each has unique pathophysiologic features that have prognostic implications for the fetus before, during and after delivery.
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