[Immediate neonatal surgery: initial experience in gastroschisis and omphalocele treatment in Northwestern Mexico].
Immediate neonatal surgery (INS) has the purpose of achieving surgical treatment of a congenital malformation in a newborn within the first few minutes after delivery. Since 1993, we have invited 15 pregnant women with sonographic diagnosis of fetal abdominal wall defect to participate in INS. All were treated by means of elective (eight cases) or emergent (seven cases) cesarean section between 33 and 38 gestational weeks. The neonates were immediately operated on the procedure beginning between 17 and 35 min after delivery. Eleven neonates had gastroschisis and primary closure was accomplished in five cases with application of auxiliary plastic patch (45.5%) and in four cases with use of native tissues only (36.4%); nine neonates survived (81.8%), and were able to be fed by mouth at 14 +/- 4.5 days. Four had omphalocele, and in three primary closure and feeding by mouth before 1 week was attained; the fourth neonate died because of coexisting malformations. The present series, even if small, is useful to affirm the safety of a procedure such as INS for both mother and child; it may contribute to improve the results of treatment of fetuses with abdominal wall defects.
Gómez-Alcalá
Alejandro V
AV
Departamento de Cirugía Pediátrica, Hospital de Especialidades 1, Centro Médico Nacional Noroeste, Instituto Mexicano del Seguro Social, Ciudad Obregón, Sonora. agomal@cob.megared.net.mx
Jiménez-Muñoz
Juan
J
Rodríguez-Rodríguez
Arnulfo
A
Ríos-Félix
Armando
A
Espino-Valle
Israel
I
Rodríguez-Hernández
Héctor
H
Macedo-García
Rolando
R
Castrejón-Martínez
Ernesto
E
Mohamed-del Bosque
Laura
L
Zárate-Miguel
Rosa Eugenia
RE
D002585:Cesarean Section; D005260:Female; D005315:Fetal Diseases; D020139:Gastroschisis / Q000175:diagnosis / Q000601:surgery*; D005865:Gestational Age; D006554:Hernia, Umbilical / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008800:Mexico; D011247:Pregnancy; D011296:Prenatal Diagnosis; D016896:Treatment Outcome