Estudio descriptivo de los nacimientos con gastrosquisis en el Centro Hospitalario Pereira Rossell
Palabras clave:
GASTROSQUISIS, NACIMIENTO
Resumen
Objetivo: conocer la situación del Centro Hospitalario Pereira Rossell (CHPR) respecto a la vía de finalización de los embarazos complicados con fetos con gastrosquisis, cuyo nacimiento tuvo lugar en este centro.
Material y método: estudio descriptivo de los recién nacidos con gastrosquisis cuyo nacimiento ocurrió en el CHPR en el período comprendido entre enero de 2005 y mayo de 2009. Se utilizaron los números registrados en la base de datos del departamento de cirugía pediátrica junto a datos recabados del libro de partos y del Sistema Informático Perinatal con vínculo a través de datos maternos.
Resultados: estos datos revelan que en nuestro centro existe una tasa de 9,82/10.000 nacimientos, incidencia mayor a la reportada internacionalmente. Se registraron 35,1% de partos vaginales en comparación con 62,2% de nacimientos mediante cesárea. No hubo diferencias significativas del peso al nacer en relación con la vía del nacimiento: 2.322,69 g en partos vaginales (± 314 g) en comparación con 2.215 g (± 391 g) mediante cesárea, ni en la edad gestacional al momento del nacimiento, siendo 36 semanas la media en ambos casos. Conclusiones: no hay diferencias significativas en cuanto a la incidencia de complicaciones tanto médicas como quirúrgicas independientemente de la vía de finalización del embarazo. La vía de nacimiento no constituye un factor pronóstico de la evolución de los recién nacidos portadores de gastrosquisis en nuestro centro hospitalario.
Citas
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(30) Holland AJ, Walker K, Badawi N. Gastroschisis: an update. Pediatr Surg Int 2010; 26(9):871-8.
(31) Vegunta RK, Wallace LJ, Leonardi MR, Gross TL, Renfroe Y, Marshall JS, et al. Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg 2005; 40(3):528-34.
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(33) Towers CV, Carr MH. Antenatal fetal surveillance in pregnancies complicated by fetal gastroschisis. Am J Obstet Gynecol 2008; 198(6):686.e1-5.
(34) Mozurkewich E, Chilimigras J, Koepke E, Keeton K, King VJ. Indications for induction of labour: a best-evidence review. BJOG 2009; 116(5):626-36.
(35) Segel SY, Marder SJ, Parry S, Macones GA. Fetal abdominal wall defects and mode of delivery: a systematic review. Obstet Gynecol 2001; 98(5 Pt 1):867-73.
(36) Hadidi A, Subotic U, Goeppl M, Waag KL. Early elective cesarean delivery before 36 weeks vs late spontaneous delivery in infants with gastroschisis. J Pediatr Surg 2008; 43(7):1342-6.
(37) Lausman AY, Langer JC, Tai M, Seaward PG, Windrim RC, Kelly EN, et al. Gastroschisis: what is the average gestational age of spontaneous delivery? J Pediatr Surg 2007; 42(11):1816-21.
(2) Pitkin RM. Screening and detection of congenital malformation. Am J Obstet Gynecol 1991; 164(4):1045-8.
(3) Australian and New Zealand Neonatal Network, Abdel-Latif ME, Bolisetty S, Abeywardana S, Lui K. Mode of delivery and neonatal survival of infants with gastroschisis in Australia and New Zealand. J Pediatr Surg 2008; 43(9):1685-90.
(4) Segel SY, Marder SJ, Parry S, Macones GA. Fetal abdominal wall defects and mode of delivery: a systematic review. Obstet Gynecol 2001; 98(5 Pt 1):867-73.
(5) Novotny DA, Klein RL, Boeckman CR. Gastroschisis: an 18-year review. J Pediatr Surg 1993; 28(5):650-2.
(6) Curry JI, McKinney P, Thornton JG, Stringer MD. The aetiology of gastroschisis. BJOG 2000; 107(11):1339-46.
(7) Goldbaum G, Daling J, Milham S. Risk factors for gastroschisis. Teratology 1990; 42(4):397-403.
(8) Tibboel D, Raine P, McNee M, Azmy A, Klück P, Young D, et al. Developmental aspects of gastroschisis. J Pediatr Surg 1986; 21(10):865-9.
(9) Amato JJ, Douglas WI, Desai U, Burke S. Ectopia cordis. Chest Surg Clin N Am 2000; 10(2):297-316.
(10) Canfield MA, Honein MA, Yuskiv N, Xing J, Mai CT, Collins JS, et al. National estimates and race/ethnic-specific variation of selected birth defects in the United States, 1999-2001. Birth Defects Res A Clin Mol Teratol 2006; 76(11):747-56.
(11) Hwang PJ, Kousseff BG. Omphalocele and gastroschisis: an 18-year review study. Genet Med 2004; 6(4):232-6.
(12) Green RF, Moore C. Incorporating genetic analyses into birth defects cluster investigations: strategies for identifying candidate genes. Birth Defects Res A Clin Mol Teratol 2006; 76(11):798-810.
(13) Rasmussen SA, Frías JL. Non-genetic risk factors for gastroschisis. Am J Med Genet C Semin Med Genet 2008; 148C(3):199-212.
(14) Hoyme HE, Higginbottom MC, Jones KL. The vascular pathogenesis of gastroschisis: intrauterine interruption of the omphalomesenteric artery. J Pediatr 1981; 98(2):228-31.
(15) Calzolari E, Bianchi F, Dolk H, Milan M. Omphalocele and gastroschisis in Europe: a survey of 3 million births 1980-1990. EUROCAT Working Group. Am J Med Genet 1995; 58(2):187-94.
(16) Werler MM, Mitchell AA, Shapiro S. Demographic, reproductive, medical, and environmental factors in relation to gastroschisis. Teratology 1992; 45(4):353-60.
(17) Feldkamp ML, Reefhuis J, Kucik J, Krikov S, Wilson A, Moore CA, et al. Case-control study of self reported genitourinary infections and risk of gastroschisis: findings from the national birth defects prevention study, 1997-2003. BMJ 2008; 336(7658):1420-3.
(18) Palomaki GE, Hill LE, Knight GJ, Haddow JE, Carpenter M. Second-trimester maternal serum alpha-fetoprotein levels in pregnancies associated with gastroschisis and omphalocele. Obstet Gynecol 1988; 71(6 Pt 1):906-9.
(19) Walkinshaw SA, Renwick M, Hebisch G, Hey EN. How good is ultrasound in the detection and evaluation of anterior abdominal wall defects? Br J Radiol 1992; 65(772):298-301.
(20) Cyr DR, Mack LA, Schoenecker SA, Patten RM, Shepard TH, Shuman WP, et al. Bowel migration in the normal fetus: US detection. Radiology 1986; 161(1):119-21.
(21) Raynor BD, Richards D. Growth retardation in fetuses with gastroschisis. J Ultrasound Med 1997; 16(1):13-6.
(22) Lindham S. Omphalocele and gastroschisis in Sweden 1965-1976. Acta Paediatr Scand 1981; 70(1):55-60.
(23) Carroll SG, Kuo PY, Kyle PM, Soothill PW. Fetal protein loss in gastroschisis as an explanation of associated morbidity. Am J Obstet Gynecol 2001; 184(6):1297-301.
(24) Moretti M, Khoury A, Rodriquez J, Lobe T, Shaver D, Sibai B. The effect of mode of delivery on the perinatal outcome in fetuses with abdominal wall defects. Am J Obstet Gynecol 1990; 163(3):833-8.
(25) Abuhamad AZ, Mari G, Cortina RM, Croitoru DP, Evans AT. Superior mesenteric artery Doppler velocimetry and ultrasonographic assessment of fetal bowel in gastroschisis: a prospective longitudinal study. Am J Obstet Gynecol 1997; 176(5):985-90.
(26) Arnold MA, Chang DC, Nabaweesi R, Colombani PM, Bathurst MA, Mon KS, Hosmane S, et al. Risk stratification of 4344 patients with gastroschisis into simple and complex categories. J Pediatr Surg 2007; 42(9):1520-5.
(27) Moir CR, Ramsey PS, Ogburn PL, Johnson RV, Ramin KD. A prospective trial of elective preterm delivery for fetal gastroschisis. Am J Perinatol 2004; 21(5):289-94.
(28) Logghe HL, Mason GC, Thornton JG, Stringer MD. A randomized controlled trial of elective preterm delivery of fetuses with gastroschisis. J Pediatr Surg 2005; 40(11):1726-31.
(29) Maramreddy H, Fisher J, Slim M, Lagamma EF, Parvez B. Delivery of gastroschisis patients before 37 weeks of gestation is associated with increased morbidities. J Pediatr Surg 2009; 44(7):1360-6.
(30) Holland AJ, Walker K, Badawi N. Gastroschisis: an update. Pediatr Surg Int 2010; 26(9):871-8.
(31) Vegunta RK, Wallace LJ, Leonardi MR, Gross TL, Renfroe Y, Marshall JS, et al. Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg 2005; 40(3):528-34.
(32) Reid KP, Dickinson JE, Doherty DA. The epidemiologic incidence of congenital gastroschisis in Western Australia. Am J Obstet Gynecol 2003; 189(3):764-8.
(33) Towers CV, Carr MH. Antenatal fetal surveillance in pregnancies complicated by fetal gastroschisis. Am J Obstet Gynecol 2008; 198(6):686.e1-5.
(34) Mozurkewich E, Chilimigras J, Koepke E, Keeton K, King VJ. Indications for induction of labour: a best-evidence review. BJOG 2009; 116(5):626-36.
(35) Segel SY, Marder SJ, Parry S, Macones GA. Fetal abdominal wall defects and mode of delivery: a systematic review. Obstet Gynecol 2001; 98(5 Pt 1):867-73.
(36) Hadidi A, Subotic U, Goeppl M, Waag KL. Early elective cesarean delivery before 36 weeks vs late spontaneous delivery in infants with gastroschisis. J Pediatr Surg 2008; 43(7):1342-6.
(37) Lausman AY, Langer JC, Tai M, Seaward PG, Windrim RC, Kelly EN, et al. Gastroschisis: what is the average gestational age of spontaneous delivery? J Pediatr Surg 2007; 42(11):1816-21.
Publicado
2013-03-31
Cómo citar
1.
Conde A, Zunini S, Sosa C. Estudio descriptivo de los nacimientos con gastrosquisis en el Centro Hospitalario Pereira Rossell. Rev. Méd. Urug. [Internet]. 31 de marzo de 2013 [citado 17 de noviembre de 2024];29(1):16-5. Disponible en: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/295
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