Document Detail


Predicting the outcome of newborns with gastroschisis.
MedLine Citation:
PMID:  19433170     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to determine factors predicting outcome in newborns with gastroschisis. METHODS: A retrospective analysis of 155 consecutive cases admitted from 1 January 1990 to 31 December 2007 was performed. Prenatal ultrasound findings were available for 89 of 155 (57%) patients and were compared with final outcome. Both univariate and multiple regression analyses were used. RESULTS: All patients survived to discharge home. The primary outcome measure was length of stay. Multiple regression identified 4 factors associated with length of stay: (1) gestational age (P = .004), (2) nonelective silo (P < .001), (3) gastrointestinal (GI) complication (intestinal atresia, perforation, or resection) (P < .001), and (4) non-GI anomaly (P = .029). Non-GI anomalies occurred in 17 of 155 (11%) patients and tended to increase the risk of a nonelective silo or GI complication (59% vs 39%, P = .190). Dilated bowel (>10 mm) on prenatal ultrasound was associated with GI complications (22% vs 3%, P = .010). However, 78% of patients with dilated bowel on prenatal ultrasound did not have a GI complication. The absence of dilated bowel on prenatal ultrasound accurately predicted the absence of GI complications in 97% of cases. CONCLUSION: Prematurity, nonelective silo, GI complications, and non-GI anomalies predict the short-term outcome of newborns with gastroschisis. Prenatal ultrasound serves primarily to predict the absence of GI complications.
Authors:
Nathaniel R Payne; Kathleen Pfleghaar; Barbara Assel; Aubrey Johnson; R Hampton Rich
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  44     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-10-14     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  918-23     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Children's Hospital and Clinics of Minnesota, Minneapolis, MN 55404, USA. rob.payne@childrensmn.org
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / epidemiology
Adult
Digestive System Abnormalities / epidemiology
Dilatation, Pathologic / embryology,  ultrasonography
Female
Gastroschisis / embryology,  epidemiology,  surgery*,  ultrasonography
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / epidemiology,  surgery,  ultrasonography
Intensive Care Units, Neonatal / statistics & numerical data
Length of Stay
Male
Maternal Age
Minnesota / epidemiology
Pregnancy
Prognosis
Retrospective Studies
Risk Factors
Ultrasonography, Prenatal*
Grant Support
ID/Acronym/Agency:
5 T-32 HD046377/HD/NICHD NIH HHS; T32 HD046377-04/HD/NICHD NIH HHS
Comments/Corrections

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