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논문 기본 정보

자료유형
학술저널
저자정보
김해영 (부산대학교) 조용훈 (부산대학교) 박수은 (부산대학교) 권재영 (부산대학교) 이동형 (부산대학교)
저널정보
대한외과학회 Annals of Surgical Treatment and Research 대한외과학회지 Vol.72 No.2
발행연도
2007.2
수록면
138 - 142 (5page)

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Purpose: The authors applied fetal stabilization and evaluated its efficacy as a therapeutic modality in the management of several congenital anomalies that can lead to perinatal respiratory distress, such as a congenital diaphragmatic hernia (CDH), large cervical lymphangioma or gastroschisis, etc.
Methods: Between Oct. 2000 and Dec. 2004, 12 newborns, with a congenital diaphragmatic hernia or gastroschisis, were observed and fetal stabilization was applied to 4 neonates. Their clinical characteristics were then retrospectively reviewed. The protocol of this procedure was as followed, (1) monitoring of the fetal respiratory movement and heart beat using Doppler ultrasonography, (2) the intravenous administration of morphine (20 to 30 ㎎) and diazepam (5 ㎎) to the mother, (3) proceed to a cesarean section when any interruptions in the fetal movement were confirmed, (4) an intravenous injection of a pancuronimum (0.5 ㎎) through the umbilical vein, (5) an immediate tracheal intubation before disruption of the placenta, (6) clamping of the umbilical cord, (7) attempt a mechanical ventilation after delivery, (8) maintain percutaneous intravenous catheterization (PIC) and (9) evaluation of the neonate.
Results: Of the 10 neonates with a CDH and the 2 with gastroschisis, fetal stabilization was applied to 3 CDH and 1 gastroschisis neonates, respectively. The survival rates were 85.7% that of conventional therapy, 66.7% for fetal stabilization in the CDH neonates and 100% for those with gastroschisis. Relatively, in those with a CDH where fetal stabilization was applied, large defects were observed and they were diagnosed at an earlier period, which could affect the mortality.
Conclusion: In our experience, fetal stabilization seems to be useful as another alternative therapeutic modality for the control of respiratory distress in the management of a CDH and gastroschisis. However, further experiences with more clinical results will be required

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UCI(KEPA) : I410-ECN-0101-2013-514-002674511