Congenital duodenal obstruction: does prenatal diagnosis improve the outcome?
Prenatal diagnosis of congenital duodenal obstruction (CDO) provides information about associated anomalies; helps plan the delivery, resuscitation, and neonatal surgery; and allows for appropriate family counseling. This report compares the outcomes of two groups of newborns: one with prenatal diagnosis of CDO (group I) and the other without (group II). Charts of the 23 newborns with CDO admitted to the Hospital of UNICAMP between 1993 and 2001 were retrospectively reviewed. Ten (44%) newborns had prenatal diagnosis of CDO. Among group I patients, the postnatal diagnosis was confirmed on the 1st day of life, whereas patients without prenatal diagnosis (group II) had the diagnosis of CDO confirmed at a mean age of 5.7 days ( p=0.004). The mean ages at surgery, at total oral feeding, and at hospital discharge were also statistically lower among infants with prenatal diagnosis, and more complications occurred in group II patients. The earlier care could explain the statistically lower morbidity for patients with prenatal diagnosis, since they were able to undergo further investigation and surgical repair before any impairment to their clinical status could take place. We believe that prenatal diagnosis of CDO, associated with earlier surgery and adequate postoperative support, can provide lower morbidity, decrease the hospitalization period, and, therefore, decrease its costs to the state and to society.
Bittencourt
Daniel Guimarães
DG
Division of Pediatric Surgery, Department of Surgery, School of Medical Sciences, Campinas State University-UNICAMP, 13276-080, Campinas-São Paulo, Brazil. daniel_bittencourt@hotmail.com
Barini
Ricardo
R
Marba
Sergio
S
Sbragia
Lourenço
L
D013505:Digestive System Surgical Procedures; D004380:Duodenal Obstruction / Q000151:congenital* / Q000175:diagnosis* / Q000601:surgery; D004386:Duodenum / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal