Le diagnostic anténatal modifie-t-il la prise en charge néonatale et le devenir à 1 an des enfants suivis pour atrésie de l’œsophage de type III ?

Abstract :

OBJECTIVE:

Evaluate neonatal management and outcome of neonates with either a prenatal or a post-natal diagnosis of EA type III.

STUDY DESIGN:

Population-based study using data from the French National Register for EA from 2008 to 2010. We compared children with prenatal versus post-natal diagnosis in regards to prenatal, maternal and neonatal characteristics. We define a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and mortality at 1 year.

RESULTS:

Four hundred and eight live births with EA type III were recorded with a prenatal diagnosis rate of 18.1%. Transfer after birth was lower in prenatal subset (32.4% versus 81.5%, P<0.001). Delay between birth and first intervention was not significantly different. Defect size (2cm vs 1.4cm, P<0.001), gastrostomy (21.6% versus 8.7%, P<0.001) and length in neonatal unit care were higher in prenatal subset (47.9 days versus 33.6 days, P<0.001). The composite variables were higher in prenatal diagnosis subset (38.7% vs 26.1%, P=0.044).

CONCLUSION:

Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity related to the EA type (longer gap). Even if it does not modify neonatal management and 1-year outcome, prenatal diagnosis allows antenatal parental counseling and avoids post-natal transfer.

Document type :
Journal articles
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https://hal.archives-ouvertes.fr/hal-01392294
Contributor : Okina Université d'Angers <>
Submitted on : Friday, November 4, 2016 - 11:26:00 AM
Last modification on : Wednesday, December 19, 2018 - 11:10:03 AM

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C Garabedian, R Sfeir, Carole Langlois, A Bonnard, N Khen-Dunlop, et al.. Le diagnostic anténatal modifie-t-il la prise en charge néonatale et le devenir à 1 an des enfants suivis pour atrésie de l’œsophage de type III ?. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Elsevier Masson, 2015, 44, pp.848-54. ⟨10.1016/j.jgyn.2014.12.004⟩. ⟨hal-01392294⟩

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