Yntema, M. (Marieke) (2021) Prenatal bowel dilatation is related to intestinal failure and prolonged TPN dependence in gastroschisis. thesis, Medicine.
Full text available on request.Abstract
Background Gastroschisis is a congenital malformation in which the intestines are herniated through an abdominal wall defect in the amniotic fluid. Postnatal prognosis with regard to bowel function is variable, and data on the prognostic value of prenatal ultrasound characteristics for the postnatal development of intestinal failure and prolonged dependence on total parenteral nutrition is inconclusive. Our objective was to assess the relationship between prenatal ultrasound characteristics and intestinal failure in gastroschisis. Methods This was a retrospective observational study of mothers who gave birth to a child prenatally diagnosed with gastroschisis in the period between January 2010 and December 2020 at the UMC Groningen. Prenatal ultrasounds were scored based on previously reported (predictive) characteristics in two time periods, i.e. an early (20-26 weeks of gestation) and a late period (30-34 weeks of gestation). The relationship between prenatal characteristics and postnatal outcomes was determined using regression analysis. Results Data of a total of 38 maternal-fetal pairs was analyzed. Delta dilatation of the extra�abdominal bowel (raw OR 1.153; 95%CI 1.005-1.323; p=0.043), i.e. the change in bowel dilatation between periods, was associated with intestinal failure. An association was observed between maximum intra-abdominal bowel dilatation and duration of total parenteral nutrition for both the early (B, 59.637; 95%CI 6.503-112.772; p=0.029) and late period (τ, 0.286; 95%CI -0.027-0.559; p=0.033). Conclusion Extra-abdominal delta dilatation, as well as the presence of intra-abdominal bowel dilatation show to be related to intestinal failure and prolonged total parenteral nutrition dependence in infants with gastroschisis.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Bruggink, J.L.M. and Prins, J.R. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 07:58 |
| Last Modified: | 06 Jan 2022 07:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2951 |
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