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Gastroschisis and omphalocele
Insights
Survival rates for infants with gastroschisis and omphalocele have significantly improved due to advancements in neonatal intensive care, including total parenteral hyperalimentation and specialized respiratory support.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Critical care medicine
Background:
- Gastroschisis and omphalocele are congenital abdominal wall defects.
- Historically, these conditions had high mortality rates.
- Advancements in medical technology and care have improved outcomes.
Purpose of the Study:
- To report the survival experience of infants with gastroschisis and omphalocele.
- To identify factors contributing to improved survival rates.
- To analyze outcomes based on defect type and year.
Main Methods:
- Retrospective review of 73 consecutive infant cases.
- Analysis of survival rates over time.
- Correlation of survival with specific medical interventions.
Main Results:
- Overall survival rate of 80 percent reported.
- Post-1973 survival rates: 87% for ruptured omphalocele, 93% for intact omphalocele, and 93% for gastroschisis.
- Significant reduction in mortality observed.
Conclusions:
- Improved survival attributed to total parenteral hyperalimentation.
- Pediatric respirators mitigating intra-abdominal pressure effects are crucial.
- Neonatal intensive care units and specialized personnel enhance infant care and survival.
Abstract:
The experience of 73 consecutive infants with gastroschisis and omphalocele is reported. The overall survival rate was 80 percent; however, since 1973 the survival rate for ruptured and intact omphaloceles has been 87 percent and 93 percent for gastroschisis. This remarkable reduction in mortality has been attributed primarily to the advent of total parenteral hyperalimentation, but mortality has also decreased due to the use of pediatric respirators which overcome the effects of increased intraabdominal pressure, and the creation of the neonatal intensive care unit where monitoring of these often fragile infants and the presence of specialty personnel assist in their care.