Thursday, June 23, 2011

Omphalocele - Pathogenesis and risk factors

Omphalocele etiology is unknown. Different theories have been postulated, including failure to return the internal organs in the abdomen in week 10-12 of pregnancy, failure of mesoderm lateral abdominal folds to migrate preombilical central and persistent body after week 12 of pregnancy.
Associated anomalies are very common-50-88%. Determine their severity outcome. It is believed that they are more common when there polihidraminos or oligohidraminos, which complicate pregnancy.
Most encountered include:-Chromosomal abnormalities, 40-60%, include trisomy 18, 13 and 21, also Turner syndrome, Klinefelter and triploid-Defects crdiace-16-47%, including atrial and ventricular septal defect, tetralogy of Fallot's, pulmonary artery stenosis, pulmonary hypoplasia, right ventricle double bicuspid aortic valve syndrome, transposition of great vessels, coarctation of the aorta, ectopia cordis, absence of the inferior vena cavaRespiratory failure is observed with giant omphaloceleGenitourinary abnormalities-40%-include extrofia bladder, anus imperforat, spinal abnormalities, ureteropelvice junction obstruction, renal malpozitia, extrofia cloacalNeural-tube defects of the head and neck and include neural tube defects, holoprosencefalul, encephalocele, cerebellar hypoplasia, cleft lip, cleft face, micrognathia, cystic higromulDigestive-40%-anomalies include: diaphragmatic hernia, malrotatia, duplicators intestinal atresia and ascites, absence of gallbladder, liver abnormal fixation, transesofageana fistula, anal imperforat-Anomalies-10-30% musculoskeletal, include: scoliosis, hemivertebra, dwarfismul camptomelic, sindactiliile, foot lime-Abnormalities maternal / fetal pregnancy include: polihidraminos, oligohidraminos, intrauterine growth restriction, single umbilical artery, cysts alantoide, chorioangiomul placental, fetal immaturity and prematurityBeckwith-Wiedemann syndrome, 5-10%, comprises a group of abnormalities involving omphalocele, macroglossia, visceromegalia.
Causes and risk factors.
One study showed that consumption of multivitamins during the preconception is associated with a decrease of 60% abnormalities. Another study shows that women younger than 20 years are at increased risk for gastroschisis during pregnancy, while those over 40 babies with omphalocele.
Factors associated with increased risk of developing omphalocele and other birth defects include: illicit drug use, smoking, alcohol consumption, maternal infections. These factors contribute to placental insufficiency and premature birth of children or low weight, those who are most often omphalocele. Hypoxia, folic acid deficiency and consumption of salicylates caused birth defects in laboratory animals. Intestinal atresia Polihidraminosul suggests.

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