Kurz- und langfristiges Outcome von Kindern mit Gastroschisis und Omphalozele im Vergleich im Zeitraum von 2000 bis 2011
Rieg, Teresa Ines
The increase in surviving neonates with abdominal wall defects (AWD) in recent decades reinforces the importance of long-term results. A survey of the quality of life (QOL) with special children’s questionnaires is still missing, as well as a sonographic evaluation of the abdomen. The lack of an uniform consensus on the optimal delivery timing of gastroschisis (GS) leads to worldwide interdisciplinary discourses. The work is based on data from 18 omphalocele (OC) and 36 GS patients treated at the University Hospital of Ulm from 01.01.2000 to 30.07.2011. The data collection was carried out by a clinical follow-up with ultrasonography of the abdomen, through inspection of files, questionnaires to pregnancy history and QOL (Kindl ® questionnaires). On clinical follow-up significantly more GS patients reported from irregular bowel movements; sonographically an increased rate of adherent bowel loops is visible in the scar area. The QOL of the 8-11 year-old children with GS showed deficits in self-esteem, body image and school. The short-term outcome of GS patients is significantly worse than that of OC- patients. The comparison of the delivery time (before or after 35 weeks of gestation) at GS results in no significant differences in outcome. On the other hand GS with inflammatory bowel loops had a significantly worse short-term outcome than children with normal intestine. The long-term outcome of children with AWD is excellent. In case of any problems, medical care should therefore be carried out by a specialized center with experienced pediatric surgery. The Kindl ® questionnaires are suitable instruments to measure quality of life in children with AWD. As an important prognostic factor for the evaluation of the short-term outcome of GS, the condition of the intestine at birth could be detected. That is why - in sonographically diagnosed dilated bowel loops - a primary cesarean section before the 35th week of gestation is recommended to protect the intestine.
Subject HeadingsBauchwand [GND]
Abdominal wall; Abnormalities [MeSH]
Outcome studies [MeSH]