morphine and Hernia--Umbilical

Topics: Abdomen, Acute; Abdominal Muscles; Angiography; Biliary Tract; Bladder Exstrophy; Enterocolitis, Pseudomembranous; Gastroesophageal Reflux; Gastrointestinal Diseases; Hernia, Diaphragmatic; Hernia, Umbilical; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units; Intestinal Atresia; Intestinal Obstruction; Meconium; Monitoring, Physiologic; Radionuclide Imaging; Ultrasonography

Reported is the analysis of morbidity, mortality, and mode of delivery in 38 cases of ventral wall defects identified from among 128,500 consecutive live births in Maine (January 1975 to December 1982). Thirteen of the ventral wall defects were classified as gastroschisis, and only one had an additional defect not directly attributable to the ventral wall defect itself. By contrast, 16 of the 25 omphalocele cases had additional defects, including eight congenital heart lesions, four genitourinary malformations, two neural tube defects, and three trisomies. Ten cases of omphalocele and one of gastroschisis died, all as a result of independent defects or involvement of adjacent structures. Intrauterine growth retardation was prominently associated with gastroschisis. Vaginal delivery occurred in three of the six ventral wall defects diagnosed antenatally and in 28 of the 32 ventral wall defects not diagnosed until delivery. The only episode of birth trauma to ventral wall defect sac or abdominal viscera occurred during cesarean section in an undiagnosed case. The present data provide a basis for prognosis and management of antenatally diagnosed ventral wall defects and suggest that these defects are not, a priori, an indication for abdominal delivery.

Topics: Abdominal Muscles; Abnormalities, Multiple; Adolescent; Adult; Amniotic Fluid; Apgar Score; Birth Weight; Delivery, Obstetric; Female; Heart Ventricles; Hernia, Umbilical; Humans; Infant Mortality; Infant, Newborn; Maine; Male; Maternal Age; Meconium; Pregnancy; Prenatal Diagnosis

Topics: Digestive System; Digestive System Abnormalities; Duodenum; Enterocolitis, Pseudomembranous; Gastrointestinal Diseases; Hernia, Umbilical; Humans; Infant, Newborn; Intestinal Obstruction; Meckel Diverticulum; Meconium; Megacolon

Topics: Anal Canal; Body Fluids; Body Water; Body Weight; Deuterium; Duodenum; Esophageal Atresia; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Jejunum; Meconium; Megacolon; Radioisotope Dilution Technique; Rectum; Tracheoesophageal Fistula; Water

Topics: Duodenum; Emergencies; Esophageal Atresia; Female; Gastrointestinal Diseases; Hernia, Diaphragmatic; Hernia, Inguinal; Hernia, Umbilical; Hernia, Ventral; Hernias, Diaphragmatic, Congenital; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Jejunum; Meconium; Pneumothorax; Pregnancy; Pyloric Stenosis; Renal Veins; Rupture; Stomach Diseases; Thrombophlebitis

Topics: Anti-Bacterial Agents; Colitis; Enema; Female; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Peritonitis; Pneumoperitoneum

Topics: Acetylcysteine; Cysteine; Cystic Fibrosis; Fetal Diseases; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Adrenal Insufficiency; Congenital Abnormalities; Cysts; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intussusception; Meconium; Megacolon; Mesenteric Vascular Occlusion; Pathology; Peritonitis; Surgical Procedures, Operative