Changes in intestinal waste products during the antenatal management of gastroschisis by serial amniotic fluid exchange and infusion.
Despite the good survival rate of fetuses with gastroschisis, the length and cost of hospitalization for surgically repaired gastroschisis are high. In gastroschisis, prolonged exposure of the intestine to amniotic fluid (AF) containing intestinal waste products results in intestinal damage, including intestinal wall thickening and fibrous peel formation. The deleterious effects of AF on gastroschisis can be prevented by lowering the concentration of intestinal waste products. We describe the treatment of a case of fetal gastroschisis by repeated AF exchange and infusion. Following repeated, successful transabdominal AF exchange and infusion, the concentrations of various intestinal waste products were decreased. AF exchange and infusion may prevent intestinal damage and improve postnatal outcome in gastroschisis by diluting the AF, probably by lowering the concentrations of intestinal waste products.
Lee
Hee-Young
HY
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Shim
Jae-Yoon
JY
Won
Hye-Sung
HS
Lee
Pil Ryang
PR
Kim
Ahm
A
D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy*; D020139:Gastroschisis / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation; D008470:Meconium; D011247:Pregnancy; D011295:Prenatal Care; D016216:Ultrasonography, Prenatal