An unusual cause of delayed full enteral feeding and prolonged hospital stay in a newborn with gastroschisis: Congenital Hypothyroidism
Main Article Content
Gastroschisis, is a prevalently encountered congenital disease of the newborns where intraabdominal organs protrude through a full-thickness defect in the anterior abdominal wall without an overlying sac. In recent years, an increase in the global incidence of gastroschisis has been reported. Although its etiology is not known fully, it is usually associated with young maternal age. Delay in the transition to full-calorie enteral feeding (ENT) in a newborn with gastroschisis is a result of bowel dysfunction which is a major morbidity developing due to exposure of bowels to amniotic fluid. Consequently, newborn may require long-term TPN treatment, and sepsis may onset secondary to prolonged mechanical ventilation, and TPN treatment, and infection,.
Global incidence of congenital hypothyroidism (CH) in live births is 1:3000-4000. Widely encountered symptoms may include prolonged jaundice, constipation, distended abdomen, and poor feeding. The diagnosis should be confirmed by finding an elevated serum TSH and low T4 or free T4 level. In the literature, transient hypothyroidism has been reported in cases who underwent only silo operation, and povidone iodine dressings,. Association of hypothyroidism with delayed transition to full enteral feeding, and prolonged hospital stay in gastroschisis has not been reported previously. In newborns with gastroschisis who underwent primary facial repair, thyroid functions should be controlled at appropriate times, and followed up closely.
Dharmraj M and Verma AP.Gastroschisis associated with lower limb and spinal congenital anomalies. J clin Neonatol. 2012; 1(4);217- 20.
Kirby RS, Marshall J, Tanner JP, Salemi JL, Feldkamp ML, Marengo L, et al. The National Birth Defects prevention Network, Prevalence and correlates of gastroschisis in 15 U.S. states: 1995- 2005. Obstet Gynecol. 2013;122: 275-81.
Ionescu S, Mocanu M, Andrei B, Bunea B, Carstoveanu C,Gurita A, Tabacaru R, Licsandru E,S tanescu D, Selleh M. Differential diagnosis of abdominal wall defects–omphalocele versus Gastroschisis. Chirurgia. 2014;109(1):7-14.
Afsarlar CE, Kendirci HNP, Erdogan D, Ozguner IF, Cavususoglu YH,Karaman A,Cetinkaya S. The first case of bruck syndrome associated with gastroschisis. The Turkish Journal ofPediatrics 2013;55:651-4.
Emily R. Christison-Lagay a, Cassandra M. Kelleher b, Jacob C. Langer a, Seminars in Fetal & Neonatal Medicine 16. 2011; 164-72.
Bradnoch TJ,Marven S, Owen A, Johnson P, Kurinczuck JJ, Spark P, Draper ES, Knight M. Gastroschisis: one year outcomes from national cohort study.BMJ.2011;343:67 49.
Overcash R, DeUgarte D, Stephenson M, Gutkin R, Norton M, Parmar S, et al. Factors associated with gastroschisis outcomes. Obstet Gynecol. 2014; 124: 551-7.
Gill SK, Broussard C, Devine O, Green RF, Rasmussen S a, Reefhuis J. Association between maternal age and birth defects of unknown etiology—United States, 1997–2007. Birth Defects Res A Clin Mol Teratol 2012;000.
Aljahdali A, Mohajerani N, Skarsgard E. Effect of timing of enteral feeding on outcome in gastroschisis. J Pediatr Surg. 2013; 48: 971-6.
Bucher B, Mazotas I, Warner B, Saito J. Effect of time to surgical evaluation on outcomes of infants with gastroschisis. J Pediatr Surg. 2012; 47: 1105-10.
Baud D, Lausman A, Alfaraj M, Seaward G, Kingdom J, Windrim R, et al. Expectant management compared with elective delivery at 37 weeks for gastroschisis. Obstet Gynecol. 2013; 121: 990-8.
Harris J, Poirier J, Selip D, Pillai S, Shah AN, Jackson CC, Chiu B. Early Closure of Gastroschisis After Silo Placement Correlates with Earlier Enteral Feeding. Journal of Neonatal Surgery 2015; 4(3):28.
Chesley PM, Ledbetter DJ, Meehan JJ, Oron AP, Javid PJ. Contemporary trends in the use of primary repair for gastroschisis in surgical infants. Am J Surg. 2015;209(5):901-5.
Wood S, Samangaya R, Gillham J, Morabito A. Gastroschisis and the risk of short bowel syndrome: outcomes and counselling. Neonatol. 2014; 105: 5-8.
Charlesworth P, Akinnola I, Hammerton C, Praveena P, Desai A, Patel S, et al. Preformed silos versus traditional abdominal wall closure in gastroschisis: 163 infants at a single institution. Eur J Pediatr Surg. 2014; 24: 88-93.
Alsheri A, Emil S, Laberge J, Skargard E. Outcomes of early versus late intestinal operations in patients with gastroschisis and intestinal atresia: results from a prospective national database. J Pediatr Surg. 2013; 48: 2022-6.
Sirichaipornsak S , Jirapradittha J, Kiatchoosakun P, Suphakunpinyo C. Neurodevelopmental outcomes of children with gastroschisis at university hospital in northeast Thailand. Asian Biomedicine. 2011; 5:6: 861-6.