Gastroschisis with intestinal atresia—predictive value of antenatal diagnosis and outcome of postnatal treatment

Ghionzoli, Marco; James, CP; David, Anna L.; Shah, Dimple; Tan, Aileen; Iskaros, J; Drake, D. P.; Curry, Joseph I.; Kiely, Edward M.; Cross, Kate; Eaton, Simon; Coppi, Paolo De; Pierro, Agostino

doi:10.1016/j.jpedsurg.2011.11.022

Cited by 46 publications

(47 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2,3 The highly variable return to functional bowel (due to chronic intestinal inflammation) and the occurrence of bowel atresia (BA; requiring intestinal surgery in ∼10%-20% of cases) are the main factors affecting length of hospital stay (LOS) as well as total parenteral nutrition (TPN) dependence and associated neonatal complications (ie, recurrent sepsis, TPN cholestasis, adhesive bowel obstruction). 2,[4][5][6] Different surgical techniques (primary vs staged closure) to repair this abdominal wall defect did not show significant differences in outcomes. 2 In developed countries, prenatal diagnosis allows a 90% detection rate of gastroschisis within the second trimester of pregnancy.…”

mentioning

confidence: 85%

“…[48][49][50] Furthermore, newborns with gastroschisis and associated BA were found to be more TPN dependent, at higher risk of chronic liver damage (eg, cholestasis), and have severe infectious complications. 5,51 Published series showed that only 60% of the time was possible to confirm an atresia at birth or during the first surgical procedure (primary closure or silo placement). 49,51,52 Even if a BA is identified at birth, the surgeon is often facing the dilemma whether performing an early or a delayed repair of the interrupted intestine.…”

Section: Implication For Clinical Practicementioning

confidence: 99%

“…Recently, several ultrasound signs, such as bowel dilatation, polyhydramnios, and bowel wall thickness (BWT), have been reported to be associated with the occurrence of unfavorable outcomes and, in particular, with BA. 5,[8][9][10][11] However, these studies were often based on small sample sizes, and the results did not reach good evidence examining single data sets in isolation.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

et al. 2015

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Gastroschisis is a congenital anomaly with increasing incidence, easy prenatal diagnosis and extremely variable postnatal outcomes. Our objective was to systematically review the evidence regarding the association between prenatal ultrasound signs (intraabdominal bowel dilatation [IABD], extraabdominal bowel dilatation, gastric dilatation [GD], bowel wall thickness, polyhydramnios, and small for gestational age) and perinatal outcomes in gastroschisis (bowel atresia, intra uterine death, neonatal death, time to full enteral feeding, length of total parenteral nutrition and length of in hospital stay).

show abstract

mentioning

confidence: 85%

Section: Implication For Clinical Practicementioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Gastroschisis is a congenital defect, which affects five in 10,000 live births 1 , characterized by an opening on the abdominal wall and exposition of bowel loops which are in contact with amniotic fluid (AF) causing a intense inflammation and changes in the intestinal morphology, affecting motility and nutrients absorption 2 .…”

Section: Introductionmentioning

confidence: 99%

Corticosteroid effect upon intestinal and hepatic interleukin profile in a gastroschisis rat model

Gonçalves

Bittencourt²,

Velloso

et al. 2013

Acta Cir. Bras.

View full text Add to dashboard Cite

Paulo (FMRP-USP). Ribeirao Preto -SP, Brazil. Mentor, conception and design of study, manuscript writing and critical revision. ABSTRACT PURPOSE:To evaluate the effect of corticosteroids on intestinal and liver interleukin profile in an experimental model of gastroschisis in fetal rats. METHODS: Sprague-Dawley rats at 19.5 days of gestation had its fetuses operated for the creation of gastroschisis. Two groups of fetuses were studied with and without maternal administration of dexamethasone. Each group was composed of fetuses who underwent gastroschisis (G), control fetuses without manipulation (C) and sham fetuses (S). A dosage of the following interleukins was carried out in fetal intestinal and liver tissues: IL-1, IL-6, IL-10, tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ). The differences between the groups and subgroups were tested by ANOVA with Tukey post-test, with significant values of p<0.05. RESULTS: Dexamethasone led to an increase in intestinal and liver IL-6 (p<0.05) and a decrease in intestinal TNF-α (p<0.001) in fetuses with gastroschisis. CONCLUSION: Corticosteroids had an effect on the intestinal interleukin profile and a small effect on the liver interleukin profile due to immunological immaturity of the fetus, and also of fetuses with gastroschisis. The steroid action may not be exclusively antiinflammatory, but also pro-inflammatory, varying with time of pregnancy.

show abstract

“…Gastroschisis is a congenital defect characterized by an opening on the abdominal wall, usually right to the umbilical cord, which affects five in 10,000 live births 1 . The permanent exposure of the bowel loops to the amniotic fluid (AF) changes the intestinal morphology, affecting motility and nutrients absorption 2 .…”

Section: Introductionmentioning

confidence: 99%

The role of gut-liver axis in the restriction of intrauterine growth in a model of experimental gastroschisis

Bueno

Gonçalves²,

Guadagnini³

et al. 2013

Acta Cir. Bras.

View full text Add to dashboard Cite

PURPOSE: To evaluate the intrauterine growth restriction (IUGR) by the expression of IR-β, IRS-1, IRS-2, IGF-IRβ and Ikappaβ in experimental model of gastroschisis. METHODS: Pregnant rats at 18.5 days of gestation were submitted to surgery to create experimental fetal gastroschisis (term = 22 days) were divided in three groups: gastroschisis (G), control (C) and sham (S). Fetuses were evaluated for body weight (BW), intestinal (IW), liver (LW) and their relations IW/BW and LW/BW. IR-β and IGF-IRβ receptors, IRS-1 and IRS-2 substrates and Ikappaβ protein were analyzed by western blotting. RESULTS: BW was lower in G, the IW and IW / BW were greater than C and S (p<0.05) groups. The liver showed no differences between groups. In fetuses with gastroschisis, compared with control fetuses, the expression of IGF-IRβ (p<0.001) and Ikappaβ (p<0.001) increased in the liver and intestine, as well as IR-β (p<0.001) which decreased in both. In contrast to the intestine, IRS-1 (p<0.001) increased in the liver and IRS-2 decreased (p<0.01). CONCLUSION: The axis of the intestine liver has an important role in inflammation, with consequent changes in the metabolic pathway of glucose can contribute to the IUGR in fetuses with gastroschisis.

show abstract

Gastroschisis with intestinal atresia—predictive value of antenatal diagnosis and outcome of postnatal treatment

Cited by 46 publications

References 40 publications

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

Corticosteroid effect upon intestinal and hepatic interleukin profile in a gastroschisis rat model

The role of gut-liver axis in the restriction of intrauterine growth in a model of experimental gastroschisis

Contact Info

Product

Resources

About