SOVREMENNAYA PEDIATRIYA.2018.1(89):97-102; doi 10.15574/SP.2018.89.97

Sliepov  O., Migur  M., Ponomarenko  O., Grasyukova  N., Tabachnikova  E.
SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS of Ukraine», Kyiv, Ukraine
Communal Health Protection Institution «Mykolaiv Regional Children's Clinical Hospital», Ukraine

Background. According to current literature, intestinal damage in gastroschisis (GS) leads to an increase in morbidity and mortality. However, the impact of intestinal affect severity on the clinical course and prognosis remains unresolved issue.
Objective: to study the influence of eventrated organs status on the clinical course and prognosis of simple gastroschisis (SGS).
Material and methods. The data of 83 patients with SGS were studied. The analysis of the frequency and nature of complications of clinical course, duration of hospitalization and levels of lethality depending on the degree of pathological changes of the evolved organs has been carried out. To investigate the influence of eviscerated organs status on the clinical course and prognosis of SGS, all patients were divided into three groups. Group 1 included patients with intact bowel (n=12; 14.5%). Newborns with moderate intestinal damage were included to the 2nd group (n=29; 34.9%). In the 3rd group, severe intestinal damage was diagnosed (n=42, 50.6%).
Results. During evaluation of the statistical significance, the significant differences of the studied parameters between the 1 and 2 groups were not detected (P>0.05; p=0.07 — 0.4). When comparing the 2nd and 3rd groups, there is a significant increase in the length of hospital stay, the mortality and complications rate (P<0.05; p=0.00510.006) among patients in the third group. In children with severe pathological changes of the eventated organs, the development of respiratory distress syndrome, sepsis, cardiovascular and multiple organ failure was significantly more frequent (P<0.05; p=0.00310.007).
Conclusions. Severe damage of eventrated organs in SGS was observed in 50.6% of patients. They have a significant impact on the incidence of clinical complications and increase the mortality of these newborns.
Key words: gastroschisis, eventrated organs status, clinical course, prognosis, newborn.
Level of evidence: level III, retrospective comparative study.

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