PDF(Pubmed)
Abstract：
UNASSIGNED: The incidence of congenital abdominal wall defects is increasing, but few cases have been reported in the African population.
UNASSIGNED: The authors report a case of gastroschisis in a term neonate who was delivered through spontaneous vaginal delivery (SVD) in a remote health facility before transfer to a tertiary hospital in Uganda. Although there was no environmental exposure to teratogens, the major risk factor of Gastroschisis, the neonate was low birth weight, HIV-exposed, and the mother had not received folic acid supplementation during the first trimester, known risk factors of gastroschisis. Physical examination revealed intrauterine growth restriction in addition to the findings of the abdominal wall defect.
UNASSIGNED: There were many missed opportunities in the management of this case which was marred by delayed essential care of the newborn, delayed surgical repair, and transfer to the tertiary surgical centre. At the tertiary surgical centre, a modified silo technique with delayed secondary closure was used to repair the defect, but the neonate still met its death before completing day 7 of life.
UNASSIGNED: This case of gastroschisis shows how the diagnosis and management of neonates born with major congenital structural abnormalities in resource-limited settings is still desirable due to lack of sophisticated medical care services to assist in early detection during pregnancy and early surgical intervention at birth to prevent associated mortality. The authors discuss the lessons learnt and provide recommendations for improvement in the care of neonates born with abdominal wall defects and other congenital birth defects.
UNASSIGNED: The authors report a case of gastroschisis in a term neonate who was delivered through spontaneous vaginal delivery (SVD) in a remote health facility before transfer to a tertiary hospital in Uganda. Although there was no environmental exposure to teratogens, the major risk factor of Gastroschisis, the neonate was low birth weight, HIV-exposed, and the mother had not received folic acid supplementation during the first trimester, known risk factors of gastroschisis. Physical examination revealed intrauterine growth restriction in addition to the findings of the abdominal wall defect.
UNASSIGNED: There were many missed opportunities in the management of this case which was marred by delayed essential care of the newborn, delayed surgical repair, and transfer to the tertiary surgical centre. At the tertiary surgical centre, a modified silo technique with delayed secondary closure was used to repair the defect, but the neonate still met its death before completing day 7 of life.
UNASSIGNED: This case of gastroschisis shows how the diagnosis and management of neonates born with major congenital structural abnormalities in resource-limited settings is still desirable due to lack of sophisticated medical care services to assist in early detection during pregnancy and early surgical intervention at birth to prevent associated mortality. The authors discuss the lessons learnt and provide recommendations for improvement in the care of neonates born with abdominal wall defects and other congenital birth defects.
摘要：
■先天性腹壁缺损的发生率正在增加，但在非洲人口中报道的病例很少。
■作者报告了一例足月新生儿腹裂病例，该新生儿在远程医疗机构通过自发阴道分娩（SVD）分娩，然后转移到乌干达的三级医院。虽然没有环境暴露于致畸剂，胃裂的主要危险因素，新生儿出生体重低，艾滋病毒暴露，母亲在孕早期没有补充叶酸，已知的腹裂危险因素。体格检查除了发现腹壁缺损外，还发现宫内生长受限。
■在这种情况下，由于新生儿的基本护理延迟而错过了许多机会，延迟手术修复,并转移到三级外科中心。在三级外科中心，采用延迟二次闭合的改良筒仓技术修复缺损，但是新生儿在完成生命的第七天之前仍然遇到了死亡。
这起腹裂病例表明，在资源有限的环境中，对出生时患有严重先天性结构异常的新生儿的诊断和治疗仍然是可取的，因为缺乏先进的医疗服务来帮助在怀孕期间的早期发现和出生时的早期手术干预，以防止相关的死亡率。作者讨论了经验教训，并为改善腹壁缺陷和其他先天性出生缺陷新生儿的护理提供了建议。
■作者报告了一例足月新生儿腹裂病例，该新生儿在远程医疗机构通过自发阴道分娩（SVD）分娩，然后转移到乌干达的三级医院。虽然没有环境暴露于致畸剂，胃裂的主要危险因素，新生儿出生体重低，艾滋病毒暴露，母亲在孕早期没有补充叶酸，已知的腹裂危险因素。体格检查除了发现腹壁缺损外，还发现宫内生长受限。
■在这种情况下，由于新生儿的基本护理延迟而错过了许多机会，延迟手术修复,并转移到三级外科中心。在三级外科中心，采用延迟二次闭合的改良筒仓技术修复缺损，但是新生儿在完成生命的第七天之前仍然遇到了死亡。
这起腹裂病例表明，在资源有限的环境中，对出生时患有严重先天性结构异常的新生儿的诊断和治疗仍然是可取的，因为缺乏先进的医疗服务来帮助在怀孕期间的早期发现和出生时的早期手术干预，以防止相关的死亡率。作者讨论了经验教训，并为改善腹壁缺陷和其他先天性出生缺陷新生儿的护理提供了建议。
