Prenatal ultrasound markers for prediction of complex gastroschisis-single-center retrospective cohort study.

OBJECTIVE: To evaluate prenatal ultrasound markers for distinguishing simple gastroschisis (sGS) from complex gastroschisis (cGS) and identifying fetuses at risk of complications. STUDY DESIGN: A retrospective cohort study analyzed 61 fetuses with isolated gastroschisis at a tertiary center from 2011 to 2021, utilizing serial ultrasounds from 14 to 35 weeks' gestation. A general linear model, quantile regression, and logistic regression assessed ultrasound markers, fetal weeks, and gastroschisis risk, yielding predictive models. RESULTS: IABL dilatation showed the highest PPV but low NPV. Non-free floating bowel loops (NFFBL) indicated the best PPV to NPV ratio. Combinations of markers yielded the highest predictive value for cGS. EABL collapsed and non-free floating bowel loops were significant, consistent risk factors. CONCLUSIONS: Prenatal ultrasounds can predict cGS risk, particularly using IABL dilatation and NFFBL as markers. Accurate assessment requires considering gestational age, qualitative symptoms, emphasizing experienced perinatologists' role and monitoring, particularly after 30 weeks of gestation.

Perinatal Outcomes of Neonates with Complex and Simple Gastroschisis after Planned Preterm Delivery-A Single-Centre Retrospective Cohort Study.

This research analysed early neonatal outcomes of complex and simple gastroschisis following planned elective preterm delivery in relation to prenatal ultrasound assessment of bowel conditions. A retrospective study of 61 neonates with prenatal gastroschisis diagnosis, birth, and management at a single tertiary centre from 2011 to 2021 showed a 96.72% survival rate with no intrauterine fatalities. Most cases (78.7%) were simple gastroschisis. Neonates with complex gastroschisis had longer hospital stays and time to full enteral feeding compared to those with simple gastroschisis-75.4 versus 35.1 days and 58.1 versus 24.1 days, respectively. A high concordance of 86.90% between the surgeon's and perinatologist's bowel condition assessments was achieved. The caesarean delivery protocol demonstrated safety, high survival rate, primary closure, and favourable outcomes compared to other reports. Prenatal ultrasound effectively evaluated bowel conditions and identified complex gastroschisis cases.

[Levels of immunoreactive cytokines in serum of women with preeclampsia or severe pregnancy hypertension]. / Stezenie immunoreaktywnych cytokin w surowicy krwi u kobiet ze stanem przed- rzucawkowym i ciezka postacia nadcisnienia ciazowego.

OBJECTIVE: The purpose of the study was to compare concentrations of inflammatory and Th1/Th2 cytokines in serum obtained from women with preeclampsia or severe pregnancy hypertension versus normotensive controls. MATERIAL AND METHODS: The study group consisted of 34 pregnant women with hypertension over 140/90mmHg and proteinuria over 0.3 g/day or severe pregnancy hypertension. 16 healthy pregnant women comprised the control group. The concentration of IL-2, IL-4, IL-6, IL-10, TNFalpha and IFNgamma was measured with Cytometric Bead Array Human Th1/Th2 Cytokine Kit II (Becton Dickinson). U-Mann Whitney test was used for the comparison of the results. RESULTS: We found statistically significantly increased concentrations of IFNgamma: 8.4 +/- 5.3 pg/ml vs. 4.2 +/- 3.2 pg/ml (p = 0.02), TNFalpha: 1.5 +/- 0.7 pg/ml vs. 0.7 +/- 0.3 pg/ml (p = 0.04) and IL-2: 1.3-0.6 pg/ml vs. 0.6 +/- 0.4 pg/ml (p = 0.01) in the studied group. The level of IL-6 35.5 +/- 21.0 pg/ml vs. 19.8 +/- 12.3 pg/ml was also increased but the difference did not reach statistical significance. Concentrations of IL-4 and IL- 10 were similar in both groups. CONCLUSION: Increased concentrations of Th1 cytokines (IFNgamma, IL-2) in the serum of women with preeclampsia suggests an exaggerated cytotoxic activity of blood in this pathology accompanied by an increase in the levels of inflammatory cytokines TNFalpha and IL-6.