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Surgical Treatment Results In Gastroschisis Based On Preterm Delivery Within The 34thWeek Of Gestation By Caesarean Section

100%
Krause H., Hass H.-J., Böttger R., Gerloff C., Rissmann A., Meyer F.
Polish Journal of Surgery
|
2015
|
vol. 87
|
issue 7
346-356
EN
The aim of the study was to assess the value of the today’s appropriate approach, preterm delivery in the 34th week of gestation by Caesarean section and subsequent surgical intervention at the perinatal center, in daily practice of pediatric surgery with regard to early postoperative and mid-term outcome. Material and methods. Over the time period of 9 years, all consecutive cases diagnosed with gastroschisis at the perinatal center, University Hospital of Magdeburg, were born by Caesarean section within the 34th week of gestation followed by surgical intervention. The registered data were compared with those published by other groups. Results. Overall, there were 19 cases through the investigation period from 01/01/2006 to 12/31/2014. The mean duration of gestation was 237.9 days. The mean birth weight was 2,276 g. In all individuals, a primary closure with no artificial material was achieved. The duration of postoperative artificial respiration was 2.3 days. Oral uptake could be initiated on the 10th postoperative day on average. The mean hospital stay was 37 days. There was no lethality. As complications, postoperative (iv catheterassociated) sepsis occurred in one case and relaparotomy became necessary in a further case because of no possible completion of enteral nutrition by 20 days after primary closure (complication and relaparotomy rate, 10.5% and 5.26%, respectively). Conclusions. The data indicate that in case of gastroschisis, primary closure can be more frequently achieved by section within the 34th week of gestation. Under the prediction of an optimal neonatological care, the risks of a preterm delivery by a planned section appear to be manageable.
2

Rola wybranych polimorfizmów genów kodujących cytokiny IL-1ß, IL1ra, IL-6 i TNFα w patogenezie porodu przedwczesnego

75%
SERAFIN M., KALINKA J.
Ginekologia i Położnictwo
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2014
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vol. 9
|
issue 3
9-23
EN
Inflammation is a known risk factor for preterm delivery (PTD). Infection in pregnant woman is responsible for up to 40% cases of PTD. Intrauterine invasion of germs, chorioamonitis, sepsis, urinary tract infections, malaria, pneumonia are diseases with proven connection with PTD. Hyper- or hypostimulation of immune system in pregnant woman may lead to inappropriate reaction for stimuli (e.g. infection), resulting in ripening of cervix, preterm premature rupture of membranes (PPROM), uterus contractility and PTD. Interleukines are proteins, which are produced as a response for inflammation. They regulate all processes that help fight infection and provide healing. As other proteins the production of interleukines is regulated by DNA. Changes in DNA like polymorphisms are responsible for e.g. inadequate production of interleukines or production of inactive praticles of protein. Single nucleotide polymorphism (SNP) is a change in one particular place in DNA chain (called locus) that is defined as a replacement in one of nucleic alkali to another. The interleukine-1 beta (IL-1ß), interleukine-6 (IL-6) and tumor necrosis factor alfa (TNFα) are proinflammatory cytokines. Particular polimorphisms in genes that codes these proteins (i.e. IL1B+3953, IL6-174 and TNFA-308 respectively) induce the inadequate production of cytokines resulting in PPROM and PTD. Interleukine-1 receptor antagonist (IL1ra) is antyinflammatory cytokine that bounds competitively with receptor for IL-1ß but gives any biological effect typical for proinflammatory IL-1b. Polymorphism in intron 2 of interleukine-1 receptor antagonist gene (IL1RN) reduces production of IL1ra, which affects balance between IL1ra and IL-1ß and leads to inadequate inflammatory response and PTD.
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