Immediate delivery room repair of fetal abdominal wall defects.
Eighteen patients with a prenatal diagnosis of fetal abdominal wall defect were delivered by cesarean section and repaired either immediately (begun within 15 min, n = 9), or by the traditional (delayed) method (n = 9, average delay = 4.4 h). Neonates repaired immediately had comparable gestational ages and birthweight, however, subjectively had less edematous bowel with less fibrous peel. These fetuses were more likely to be closed primarily (7/9 vs. 4/9), spent less time on a ventilator (8.1 vs. 17.9 days), seemed to be fed sooner (7.6 vs. 17.9 days), and discharged home earlier (14.3 vs. 24.0 days). Our results suggest that for fetuses delivered by cesarean section, early defect repair may reduce bowel edema and fibrous peel formation thus facilitating primary closure, with earlier ventilator weaning, feeding and discharge home.
Blessed
W B
WB
Department of Obstetrics and Gynecology, Hutzel and Sinai Hospital, Detroit, Mich.
Coughlin
J P
JP
Johnson
M P
MP
Evans
M I
MI
Jewell
M R
MR
Goyert
G L
GL
Schwartz
D B
DB
Klein
M D
MD
D000009:Abdominal Muscles / Q000002:abnormalities* / Q000601:surgery*; D001724:Birth Weight; D002585:Cesarean Section; D016009:Chi-Square Distribution; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005500:Follow-Up Studies; D005865:Gestational Age; D006554:Hernia, Umbilical / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007902:Length of Stay; D011247:Pregnancy; D012121:Respiration, Artificial; D013997:Time Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal