Effect of amnioinfusion on the outcome of prenatally diagnosed gastroschisis.
OBJECTIVE
Following recent data showing that an inflammatory response exists in the amniotic fluid of gastroschisis-affected fetuses, we hypothesized that amniotic fluid exchange or amnioinfusion would improve the prognosis of prenatally diagnosed gastroschisis.


METHODS
We compared the outcome of prenatally amnioinfused fetuses with gastroschisis to non-amnioinfused fetuses with gastroschisis. 10 patients undergoing this procedure were matched with 10 patients of our previous study. Comparisons were done on data including surgical procedure, follow-up in the NICU and the gastro-pediatric unit.


RESULTS
Our results show that gastroschisis-affected fetuses undergoing amnioinfusion had a lower duration of curarization after surgery (2.2 +/- 1.9 vs. 6.8 +/- 6.9 days, p = 0.019), a shorter delay before full oral feeding (49.7 +/- 21.5 vs. 72.3 +/- 56.6 days, NS), and a shorter overall length of hospitalization (59.5 +/- 19.7 vs. 88.5 +/- 73.6 days, NS). We confirmed our previous data showing that amniotic fluid displays a chronic inflammation profile.


CONCLUSIONS
Our data suggest that amnioinfusion could improve the outcome of gastroschisis affected fetuses. The hypothesis by which this improvement could be due to a reduction of an inflammatory response remains to be proved.
Luton
D
D
Département de périnatalogie, Hôpital Robert-Debré, Paris, France. luti@club-internet.fr
de Lagausie
P
P
Guibourdenche
J
J
Oury
J
J
Sibony
O
O
Vuillard
E
E
Boissinot
C
C
Aigrain
Y
Y
Beaufils
F
F
Navarro
J
J
Blot
P
P
D000328:Adult; D000650:Amnion; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000628:therapy; D007267:Injections; D011247:Pregnancy; D012965:Sodium Chloride / Q000627:therapeutic use*; D016216:Ultrasonography, Prenatal
D012965:Sodium Chloride