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Birth Defects Research Nov 2019In this report, the National Birth Defects Prevention Network (NBDPN) examines and compares gastroschisis and omphalocele for a recent 5-year birth cohort using data...
BACKGROUND/OBJECTIVES
In this report, the National Birth Defects Prevention Network (NBDPN) examines and compares gastroschisis and omphalocele for a recent 5-year birth cohort using data from 30 population-based birth defect surveillance programs in the United States.
METHODS
As a special call for data for the 2019 NBDPN Annual Report, state programs reported expanded data on gastroschisis and omphalocele for birth years 2012-2016. We estimated the overall prevalence (per 10,000 live births) and 95% confidence intervals (CI) for each defect as well as by maternal race/ethnicity, maternal age, infant sex, and case ascertainment methodology utilized by the program (active vs. passive). We also compared distribution of cases by maternal and infant factors and presence/absence of other birth defects.
RESULTS
The overall prevalence estimates (per 10,000 live births) were 4.3 (95% CI: 4.1-4.4) for gastroschisis and 2.1 (95% CI: 2.0-2.2) for omphalocele. Gastroschisis was more frequent among young mothers (<25 years) and omphalocele more common among older mothers (>40 years). Mothers of infants with gastroschisis were more likely to be underweight/normal weight prior to pregnancy and mothers of infants with omphalocele more likely to be overweight/obese. Omphalocele was twice as likely as gastroschisis to co-occur with other birth defects.
CONCLUSIONS
This report highlights important differences between gastroschisis and omphalocele. These differences indicate the importance of distinguishing between these defects in epidemiologic assessments. The report also provides additional data on co-occurrence of gastroschisis and omphalocele with other birth defects. This information can provide a basis for future research to better understand these defects.
Topics: Abdominal Wall; Abnormalities, Multiple; Adult; Congenital Abnormalities; Digestive System Abnormalities; Female; Gastroschisis; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Live Birth; Male; Maternal Age; Middle Aged; Mothers; Population Surveillance; Pregnancy; Prevalence; Racial Groups; Registries; Risk Factors; United States
PubMed: 31642616
DOI: 10.1002/bdr2.1607 -
Scientific Reports Jan 2021Analyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated...
Analyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3-5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9-5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6-3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2-3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.
Topics: Abdominal Wall; Case-Control Studies; Female; Fetus; Gastroschisis; Gestational Age; Hernia, Abdominal; Hernia, Umbilical; Humans; Male; Pregnancy
PubMed: 33420099
DOI: 10.1038/s41598-020-79599-y -
Annals of the Royal College of Surgeons... Sep 2021
Topics: Child; Child, Preschool; Female; Follow-Up Studies; Hernia, Umbilical; Herniorrhaphy; Humans; Infant; Male; Suture Techniques; Treatment Outcome
PubMed: 34464570
DOI: 10.1308/rcsann.2021.0113 -
Chirurgia (Bucharest, Romania : 1990) 2014Omphalocele is a congenital abnormality whose prognosis has improved significantly over the last few decades, reaching a survival rate of 80-90% in developed countries....
BACKGROUND
Omphalocele is a congenital abnormality whose prognosis has improved significantly over the last few decades, reaching a survival rate of 80-90% in developed countries. Currently, in Romania no comprehensive study on the incidence, treatment, and survival of patients with this defect of the anterior abdominal wall has been carried out.
METHODS
This retrospective analytical study was conducted over a period of 23 years and included 105 children with omphalocele. Prenatal diagnosis, referral to our hospital, children age upon admission, associated diseases, medical and surgical management, early and late postoperative complications, and the length of hospital stay were analysed.
RESULTS
The low rate of antenatal diagnosis (13.3%), the high frequency of associated congenital malformations (71.4%) and chromosomal abnormalities (27.6%), inadequate and delayed transport to a specialized pediatric surgery center together with an increased rate of sepsis (37.1%)resulted in a high mortality rate (54.3%).
CONCLUSIONS
The significantly reduced length of hospital stay and higher survival rate despite the apparently more frequent medical complications plead for the surgical treatment of omphalocele whenever not contraindicated by the presence of severe pulmonary hypoplasia, cardiac defects, immaturity and other severe congenital anomalies, when conservative treatment is indicated.
Topics: Abnormalities, Multiple; Chromosome Aberrations; Female; Follow-Up Studies; Hernia, Umbilical; Herniorrhaphy; Humans; Infant, Newborn; Length of Stay; Male; Prognosis; Retrospective Studies; Risk Factors; Romania; Survival Rate; Treatment Outcome; Ultrasonography, Prenatal
PubMed: 25149614
DOI: No ID Found -
Annals of Surgery Dec 1980Until recently confusion has existed concerning the clinical features and surgical treatment of gastroschisis and omphalocele. Since 1971 75 infants with these abdominal...
Until recently confusion has existed concerning the clinical features and surgical treatment of gastroschisis and omphalocele. Since 1971 75 infants with these abdominal wall defects have been treated at our institution. Significant differences (p equal to 0.001 in all instances) were noted between the two diseases. Gastroschisis occurred twice as often as omphalocele and is increasing in frequency. Prematurity was commonly seen with gastroschisis (65%). While the overall incidence of malformations associated with gastroschisis was low (23%), the vast majority of the additional malformations were jejunoileal or colonic atresias. The mortality rate was 12.7% among gastroschisis patients, with only one death attributable to prematurity. All other deaths were preventable, indicating that even lower mortality rates are feasible. Omphalocele was associated with a 23% incidence of premature birth but associated anomalies were present in 66% of the patients. Major cardiac (52%) and chromosomal defects (40%) predominated. In addition, 17% of omphalocele patients had either Cantrell's pentalogy or cloacal/bladder exstrophy. The mortality rate in omphalocele (34%) was nearly three times that of gastroschisis. Nine of ten patients who died from omphalocele died either from major cardiac or chromosomal disease. However, in patients without cardiac or chromosomal defects the survival rate was 94%.
Topics: Abdominal Muscles; Abnormalities, Multiple; Colon; Congenital Abnormalities; Female; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Premature; Intestine, Small; Male
PubMed: 6449913
DOI: 10.1097/00000658-198012000-00015 -
Chirurgia (Bucharest, Romania : 1990) 2020The risk of developing an abdominal wall hernia is high in the cirrhotic patient, due to the association of ascites, hypoalbuminemia and amyotrophy in connection with... (Review)
Review
The risk of developing an abdominal wall hernia is high in the cirrhotic patient, due to the association of ascites, hypoalbuminemia and amyotrophy in connection with undernutrition frequently associated with cirrhosis. Thus, almost 20% of cirrhotic patients develop an umbilical hernia. Parietal surgery is more at risk in cirrhotic patients and its indications must be discussed on a case-by-case basis. The objective of this work was to review the entire literature on wall surgery in order to best define the surgical indications and the specifics of their management. The bibliographic research was done on Pubmed over the period from January 1995 to December 2019, using French and English as publication languages. The keywords retained were "hernia" [Mesh] and "liver cirrhosis" [Mesh]. In an elective situation, preoperative ascites control is recommended. A parietal prosthesis can be used, even in the case of uninfected ascites, preferably in the retromuscular position. Laparoscopy should be used with caution, due to the bleeding risk. No recommendation can be made on the use of prophylactic intra-abdominal drainage. The literature data do not allow the trans-jugular route portosystemic shunt recommendation, nor the use of a peritoneal-vesical pump to decrease the volume of ascites before parietal surgery in cirrhotic patients.
Topics: Abdominal Wall; Ascites; Hernia, Umbilical; Hernia, Ventral; Herniorrhaphy; Humans; Liver Cirrhosis
PubMed: 32369717
DOI: 10.21614/chirurgia.115.2.140 -
Romanian Journal of Morphology and... 2012A number of syndromes÷associations involving the caudal region have been described in the literature. Each of them is characterized by a set of morphological features.... (Review)
Review
BACKGROUND
A number of syndromes÷associations involving the caudal region have been described in the literature. Each of them is characterized by a set of morphological features. Reports on difficulties in delineation and an ever-increasing constellation of defects in recent past call for a comprehensive study into the morphologic presentations and pathogenesis of caudal embryonic defects.
MATERIALS AND METHODS
The present article describes a case of the OEIS complex--a combination of omphalocele, exstrophy of bladder, imperforate anus and spinal defects. Literature search was performed and morphologic presentations, as described in literature, of all syndromes and associations affecting the caudal region of the embryo have been compared. Morphologic presentations were analyzed embryologically.
RESULTS
A remarkable overlap of symptom complex was observed. Embryological analysis of the phenotypic presentations of all these syndromes points towards a common pathogenesis, early in the embryonic life. The embryologic analysis suggests that these defects are a result of defects in proliferation, migration or subsequent differentiation of any of the three subdivisions of intra-embryonic mesoderm.
CONCLUSIONS
Based on the analysis a new hypothesis for the causation of caudal defects is proposed. This hypothesis suggests that a local internal environmental imbalance, at the site of implantation, can cause nutritional insult to the embryo during gastrulation, during the third and the early fourth week of embryonic life.
Topics: Anus, Imperforate; Bladder Exstrophy; Cauda Equina; Hernia, Umbilical; Humans; Prenatal Diagnosis
PubMed: 23303026
DOI: No ID Found -
Pediatric Surgery International May 2020Major congenital abdominal wall defects (gastroschisis and omphalocele) may account for up to 21% of emergency neonatal interventions in low- and middle-income... (Review)
Review
Major congenital abdominal wall defects (gastroschisis and omphalocele) may account for up to 21% of emergency neonatal interventions in low- and middle-income countries. In many low- and middle-income countries, the reported mortality of these malformations is 30-100%, while in high-income countries, mortality in infants with major abdominal wall reaches less than 5%. This review highlights the challenges faced in the management of newborns with major congenital abdominal wall defects in the resource-limited setting. Current high-income country best practice is assessed and opportunities for appropriate priority setting and collaborations to improve outcomes are discussed.
Topics: Abdominal Wall; Disease Management; Gastroschisis; Health Resources; Hernia, Umbilical; Humans; Incidence; Infant; Infant Mortality; Infant, Newborn
PubMed: 32200405
DOI: 10.1007/s00383-020-04638-8 -
Singapore Medical Journal Jan 2008Two of the most common malformations of the anterior abdominal wall include gastroschisis and omphalocele, both of which are associated with high morbidity and...
INTRODUCTION
Two of the most common malformations of the anterior abdominal wall include gastroschisis and omphalocele, both of which are associated with high morbidity and mortality. Studies have shown an increase in both conditions worldwide. These two conditions are considered separate entities because of their differences in epidemiology, physical characteristics and associations with other structural anomalies and chromosomal aberrations. This is the first local study to examine these two conditions.
METHODS
Data of anterior abdominal wall defect cases of patients born during the period 1993-2002 were retrieved from the National Birth Defects Registry and analysed.
RESULTS
There were a total of 121 cases of anterior abdominal wall defects in the ten-year period from 1993 to 2002, giving an overall incidence of 2.63 per 10,000 livebirths. The individual incidences of gastroschisis (n = 21) and omphalocele (n = 100) were 0.46 and 2.17 per 10,000 livebirths, respectively. 33 percent of women with foetal gastroschisis were younger than 25 years of age, and 31 percent of women with foetal omphalocele were older than 35 years of age. This was statistically significant when compared to the general obstetric population. Incidence of omphalocele was lowest among the Indian population. Total aneuploidy rate was 14.9 percent (18/121 cases), with omphalocele having a higher aneuploidy rate than gastroschisis (17 percent versus 4.8 percent). Omphaloceles are also more likely to be associated with cardiac defects (p-value equals 0.02).
CONCLUSION
Our studies are consistent with the worldwide trend of an increasing prevalence of anterior abdominal wall defects. The race-specific differences suggest genetic and environmental factors that warrant further studies.
Topics: Adult; Chromosome Aberrations; Congenital Abnormalities; Female; Gastroschisis; Hernia, Umbilical; Humans; Incidence; Male; Maternal Age; Middle Aged; Registries; Singapore; Time Factors
PubMed: 18204766
DOI: No ID Found -
Pediatric Surgery International Dec 2022
Topics: Humans; Gastroschisis; Hernia, Umbilical; Abdominal Wall
PubMed: 36484852
DOI: 10.1007/s00383-022-05290-0