Do neonates conceived after assisted reproductive technology require neonatal surgery more frequently? A 5-year single-center experience.

AIM: Assisted reproductive technology (ART) has increased the incidences of multiple gestations and low birth weights, which frequently warrant pediatric surgery. ART may have also increased the rate of birth defects. In this study, we aimed to determine whether infants conceived after ART required neonatal surgery more frequently compared with naturally conceived infants. MATERIAL AND METHODS: Our study population comprised 1891 infants (160 ART (+) and 1731 ART (-)) who were admitted to our neonatal intensive care unit during a 5-year period (January 2006-December 2010); of these, 198 infants (9 ART (+) and 189 ART (-)), with diseases requiring surgery, were referred to pediatric surgeons (consultation cases). We examined the following: (i) factors potentially increasing the requirement for surgery; (ii) frequency of birth defects; and (iii) maternal factors that may increase the need for surgery. RESULTS: A significantly higher incidence of multiple gestation and low birth weight was observed in the ART (+) group than the ART (-) group. However, ART did not yield a higher rate of surgery and birth defects: overall, the rate of surgery was 4% (7/160) in the ART (+) group and 8% (143/1731) in the ART (-) group. Of 198 consultation cases, the percentage of infants actually requiring surgery was approximately the same in the ART (+) group (7/9 [78%]) and the ART (-) group (143/189 [76%]). CONCLUSION: Infants conceived after ART comprised a small proportion of neonatal surgery cases, and did not require surgery more frequently.

Aortogenic cerebrovascular accident.

A 59-year-old man was transferred to our hospital because of mural thrombus in the ascending aorta. He had suffered some neurological dysfunctions such as transient dysorientation. Electrocardiogram showed normal sinus rhythm without premature beats. Trans-thoracic echocardiogram and three-dimensional CT showed a mobile mural mass sticking to the ascending aortic wall. No coagulopathy was detected in the patient. The mural masses were thought to be a possible cause of the repeated cerebro-vascular symptoms. Under cardiopulmonary bypass and cardiac arrest, the masses were removed including the mass sticking to the aortic wall. Postoperative pathological findings showed the masses were organizing thrombi that had originated from the atherosclerotic aortic wall. Postoperative course was uneventful, and the patient was doing well one year after the operation without neurological dysfunction.