Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Objective:To investigate risk factors of death in newborns with congenital diaphragmatic hernia (CDH). Method:A total of 126 newborns with CDH from June 2012 to September 2018 were enrolled. Concomitant malformations were recorded by descriptive analysis. Newborns received surgical treatment (n=120) for CDH were divided into survival group and fatal group. The risk factors of death were analyzed by univariate and multivariate logistic regression and the ROC curve with generated with relevant variables. Result:There were 55 CDH newborns with concomitant malformations (43.7%), including 20 cases (15.9%) with multi-malformation. Logistic regression analysis showed that premature rupture of membranes (PROM), postoperative atelectasis, long duration of postoperative mechanical ventilation, postoperative high oxygenation index (OI) were related to death (all P<0.05), and the delayed surgery was a protective factor (P<0.05). In ROC analysis of postoperative OI in predicting death, the area under the curve (AUC) was 0.841, with the cutoff value of 5.74, the sensibility and specificity of OI was 81.0% and 75.0%, respectively(P<0.01). Conclusions:Newborns with CDH have a high rate of malformations. The risk factors of death were PROM, postoperative atelectasis, postoperative long duration of mechanical ventilation and higher postoperative OI, and delayed surgery may reduce mortality.
Zhejiang Da Xue Xue Bao Yi Xue Ban 2019 May 25
PMID:[Risk factors of death in newborns with congenital diaphragmatic hernia]. 3110 62

A 21-year-old woman was admitted at 35 +4 weeks due to disappearance of fetal movement for one day. The ultrasound from other hospital indicated fetal gastroschisis. Abdominal ultrasound in our hospital confirmed that the discontinuity of the fetal abdominal wall by 4.5 cm. The stomach and part of the intestine were herniating into the amniotic cavity. Considering the possibility of gastroschisis and fetal distress, electronic fetal monitoring was implemented continuously and consultations of relevant departments were called immediately, including anesthesiology, neonatology and general pediatric surgery. After Cesarean section under general anesthesia, pediatric surgeons performed an intrapartum surgery for the neonate. The tension of abdominal wall was slightly higher after the operation, but had no significant negative effect on ventilation. After surgery, the neonate was transferred to neonatal pediatrics for further treatments. The abdominal distention of the neonate relieved gradually. The patient was discharged after receiving full enteral nutrition without any discomfort. It was found in the follow-up that the patient had no discomforts such as infection, wound dehiscence, intestinal necrosis, abdominal hernia or other complications. The prenatal examinations should be completed and the pregnant mother of gastroschisis fetus should be transferred to the experienced center where the intrapartum surgery or early stage I repair surgery is possible for the neonate.
Sichuan Da Xue Xue Bao Yi Xue Ban 2020 Sep
PMID:[A Case of Congenital Gastroschisis Repair of a Newborn Following the Cesarean Section]. 3297 94