Neonatal survival of prenatally diagnosed exomphalos

Patel, Gaural; Sadiq, Javaid; Shenker, Natalie; Impey, Lawrence; Lakhoo, Kokila

doi:10.1007/s00383-009-2357-3

Cited by 27 publications

(17 citation statements)

References 9 publications

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“…First, we did not directly study the association between gene polymorphisms and the plasma ACE and AGT levels. However, the ACE DD genotype has been clearly associated with the higher plasma and tissue levels of ACE [17, 40, 41]. In addition, Jeunemaitre et al [18] have found a greater association between the AGT TT genotype and higher plasma AGT levels, compared to that of the AGT MM genotype.…”

Section: Discussionmentioning

confidence: 99%

Gender-Dependent Effect of ACE I/D and AGT M235T Polymorphisms on the Progression of Urinary Albumin Excretion in Taiwanese with Type 2 Diabetes

Tien

Hsiao²,

Hsu³

et al. 2008

Am J Nephrol

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Background: We investigated the gender differences in the effect of ACE I/D and AGT M235T polymorphisms on the prognosis of diabetic nephropathy (DN). Methods: A total of 525 type 2 diabetics were enrolled to participate in this prospective observational study. ACE and AGT gene polymorphisms were analyzed by polymerase chain reaction. The progression of DN was defined as a shift to a higher stage of DN or a doubling of the baseline serum creatinine level by the end of the study. Results: The baseline biophysical parameters show no gender differences in progression and non-progression of DN. The women who were ACE D allele carriers were found to be at an increased risk of DN progression compared to those with II genotypes (p = 0.024, OR 2.176). No such difference was seen in male patients (p = 0.619, OR 0.833). After adjusting for confounding factors (age, SBP, DBP, BMI, HbA1c, total cholesterol, TG, HDL-C, LDL-C, ACEI, and ARB) in our multiple regression analysis, these women were still found to be at increased risk of progressing to more severe DN (p = 0.008, OR 3.082) but not the men (p = 0.183, OR 0.586). Neither the AGT TT genotype nor the T allele were associated with the progression of DN in either sex after adjusting for confounding factors. Conclusion: Our follow-up study suggests that female diabetic carriers of the ACE D allele might be at an increased risk of DN progression.

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Section: Discussionmentioning

confidence: 99%

Gender-Dependent Effect of ACE I/D and AGT M235T Polymorphisms on the Progression of Urinary Albumin Excretion in Taiwanese with Type 2 Diabetes

Tien

Hsiao²,

Hsu³

et al. 2008

Am J Nephrol

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“…As Patel et al [4] reported, the existence of associated anomalies affects prognosis more than the severity of the omphalocele itself, and antenatal evaluation of the associated anomalies is useful to enable appropriate care immediately after birth. In this study, chromosomal aneuploidy was observed in 36.8% of cases, and associated anomalies, including chromosomal aberrations, were detected in 76.3%; these findings are similar to those in previous reports.…”

Section: Discussionmentioning

confidence: 99%

Congenital Omphalocele and Polyhydramnios: A Study of 52 Cases

et al. 2011

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Introduction: Unlike gastroschisis, congenital omphalocele is often associated with other anomalies and is frequently complicated by polyhydramnios. We examined the relationships between polyhydramnios, pregnancy outcome and fetal prognosis.Patients and Methods: Clinical data from cases diagnosed antenatally with congenital omphalocele from 1993 to 2006 were analyzed retrospectively. Results: Fifty-two cases were diagnosed antenatally with congenital omphalocele, and 38 of these pregnancies resulted in delivered infants. Of these 38 pregnancies, 55.3% were preterm births before 37 weeks of gestation. The mean birth weight was 2,148 g (n = 38). Associated anomalies were recognized in 29 cases (76.3%), including 13 cases (34.2%) of chromosomal aberrations. There were 2 cases of trisomy 13, 10 cases of trisomy 18 and 1 case of trisomy 21. Polyhydramnios was detected in 14 cases (36.8%), and other anomalies were present in all of these cases. Discussion: For antenatal evaluation in cases of congenital omphalocele, it is important to examine the fetus for associated anomalies or underlying disease, especially when polyhydramnios is detected.

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“…The definition of big or giant omphalocele published in previous studies is heterogeneous and include presence of the liver in the omphalocele sac [11], more than 75% of the liver in the omphalocele sac [12] or the entire liver in the omphalocele sac [10]. Therefore, comparison of results across different studies that have evaluated prognosis in cases diagnosed antenatally is difficult.…”

Section: Introductionmentioning

confidence: 98%

“…When omphalocele is an isolated finding, survival rates following surgical repair are over 90% [8,9,10]. Nevertheless, increased postnatal morbidity and surgical pitfalls are related to the size of the herniated content and giant defects, which include the liver [11].…”

Section: Introductionmentioning

confidence: 99%

Should We Measure Fetal Omphalocele Diameter for Prediction of Perinatal Outcome?

Kiyohara

Brizot²,

Liao³

et al. 2013

Fetal Diagn Ther

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Objective: To evaluate the fetal omphalocele diameter/abdominal circumference ratio (OD/AC) as a predictor of adverse perinatal outcome. Methods: Analysis involving 47 singleton pregnancies with fetal omphalocele, normal karyotype and absence of other major abnormalities. The OD/AC ratio was determined antenatally by ultrasound and the best cutoff for the prediction of neonatal death was determined by receiver operating characteristic curve analysis. Additional secondary outcomes included need for oral intubation in the first 24 h of life, two-step surgery or use of synthetic mesh, reoperation, parenteral feeding and need for respiratory assistance >21 days, time to first oral feed, and time to hospital discharge. Results: Fetal OD/AC did not change significantly with gestational age. Postnatal death occurred in 10 (21.3%) cases and the best cutoff for prediction was an OD/AC ratio ≥0.26. In pregnancies with the first ultrasound evaluation performed before 31 weeks' gestation and an OD/AC ≥0.26, the likelihood ratio for needing intubation in the first 24 h of life was 2.6 (95% CI: 1.2-5.7), needing two-step surgery or use of mesh was 4.9 (95% CI: 1.9-14.4), and postnatal death was 4 (95% CI: 1.9-7.5). Conclusion: A fetal ultrasound OD/AC ratio ≥0.26 is associated with increased postnatal morbidity and mortality.

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Neonatal survival of prenatally diagnosed exomphalos

Cited by 27 publications

References 9 publications

Gender-Dependent Effect of ACE I/D and AGT M235T Polymorphisms on the Progression of Urinary Albumin Excretion in Taiwanese with Type 2 Diabetes

Gender-Dependent Effect of ACE I/D and AGT M235T Polymorphisms on the Progression of Urinary Albumin Excretion in Taiwanese with Type 2 Diabetes

Congenital Omphalocele and Polyhydramnios: A Study of 52 Cases

Should We Measure Fetal Omphalocele Diameter for Prediction of Perinatal Outcome?

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