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Antenatal diagnosis and perinatal care of anterior abdominal wall defects

Published online by Cambridge University Press:  10 October 2008

Hratch L Karamanoukian ,
Stuart J O'Toole  and
Philip L Glick
Hratch L Karamanoukian
Affiliation:
Buffalo Institute of Fetal Therapy (BIFT), Department of Surgery State University of New York at Buffalo, New York, USA
Stuart J O'Toole
Affiliation:
Buffalo Institute of Fetal Therapy (BIFT), Department of Surgery State University of New York at Buffalo, New York, USA
Philip L Glick*
Affiliation:
Buffalo Institute of Fetal Therapy (BIFT), Department of Surgery State University of New York at Buffalo, New York, USA Buffalo Institute of Fetal Therapy (BIFT)Departments of Pediatrics State University of New York at Buffalo, New York, USA
*
Philip L Glick MD, Buffalo Institute of Fetal Therapy, Children's Hospital of Buffalo, State University of New York at Buffalo, 219 Bryant Street, Buffalo, NY 14222, USA.
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Extract

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.

Type
Articles
Information
Fetal and Maternal Medicine Review , Volume 7 , Issue 3 , August 1995 , pp. 109 - 127
Copyright
Copyright © Cambridge University Press 1995

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