scholarly journals Abdominal Wall Defects Among Mexican American Infants: The Effect of Maternal Nativity

2016 ◽  
Vol 26 (2) ◽  
pp. 165 ◽  
Author(s):  
Shayna D. Hibbs ◽  
Amanda Bennett ◽  
Yessenia Castro ◽  
Kristin M. Rankin ◽  
James W. Collins, Jr.

<p><strong>Background</strong>: US-born Mexican American women have greater rates of preterm birth and consequent overall infant mortality than their Mexico-born peers. However, the relation of Mexican American women’s<br />nativity to rates of congenital anomalies is poorly understood. Hispanic ethnicity and young maternal age are well-known risk factors for gastroschisis.</p><p><br /><strong>Objective</strong>: To determine the extent to which nativity of Mexican American women is associated with abdominal wall defects.</p><p><strong>Methods</strong>: Stratified and multivariable logistic regression analyses were performed on the 2003-2004 National Center for Health Statistics linked live birth-infant death cohort. Only Mexican American infants were studied. Maternal variables examined included nativity, age, education, marital status, parity, and prenatal care usage.</p><p><strong>Results:</strong> Infants with US-born Mexican American mothers (n=451,272) had an abdominal wall defect rate of 3.9/10,000 compared with 2.0/10,000 for those with Mexico-born mothers (n=786,878), RR=1.9 (1.5-2.4). Though a greater percentage of US-born (compared wtih Mexico-born) Mexican American mothers were teens, the nativity disparity was actually widest among women in their 20s. The adjusted (controlling for maternal age, education, marital status, parity, and prenatal care) odds ratio of abdominal wall defects among infants of US-born (compared with Mexico-born) Mexican American mothers was 1.6 (1.2-2.0).</p><p><strong>Conclusions</strong>: US-born Mexican American women have nearly a two-fold greater rate of delivering an infant with an abdominal wall defect than their Mexico-born counterparts. This phenomenon is only partially explained by traditional risk factors and highlights a detrimental impact of lifelong residence in the United States, or something closely related to it, on the<br />pregnancy outcome of Mexican American women. Ethn Dis; 2016;26(2):165-170; doi:10.18865/ed.26.2.165</p>

2019 ◽  
Vol 23 (3) ◽  
pp. 197-203
Author(s):  
Brittany Ruschkowski ◽  
Anthea Lafreniere ◽  
Dina El Demellawy ◽  
David Grynspan

Gastroschisis is a congenital abnormality characterized by visceral herniation through an abdominal wall defect. While the cause of gastroschisis is unknown, it has been linked to risk factors including young maternal age, smoking, and alcohol use during pregnancy. To date, the only established placental correlate is amniocyte vacuolization. Based on our clinical experience, we hypothesized that delayed villous maturation (DVM) is also associated with gastroschisis. We conducted a retrospective slide review of 23 placentas of neonates with gastroschisis. Additionally, we selected 2 control groups of placentas: 1 with a previous diagnosis of DVM and 1 with normal villous morphology. All placentas were randomized and reviewed by 2 perinatal pathologists, who were blinded to the group; DVM and amniocyte vacuolization were assessed. Gastroschisis was associated with increased placental DVM in 65.2% of cases (vs 13.6% of controls; P = .0007) and increased amniocyte vacuolization in 52.2% of cases (vs 9.1% of controls; P = .003) compared to the control group. Based on the normal and DVM groups, kappa agreement between current slide review and initial pathology diagnosis was 0.419, indicating moderate agreement. Our study shows that gastroschisis is associated with placental DVM. This association may be due to (1) a common upstream factor contributing to both gastroschisis and DVM or (2) DVM may be a consequence of the altered placental and amniotic environment in the context of gastroschisis.


2006 ◽  
Vol 72 (7) ◽  
pp. 637-640 ◽  
Author(s):  
Kenneth W. Gow ◽  
Amina Bhatia ◽  
Daniel F. Saad ◽  
Mark L. Wulkan ◽  
Kurt F. Heiss

Gastroschisis is a periumbilical, abdominal wall defect arising to the right of the umbilicus. We describe the clinical course of a left-sided gastroschisis in a term female born at 39 weeks’ gestation. To our knowledge, there have been only 14 left-sided abdominal wall defects reported in the literature. We discuss our case and review the literature to try to determine if there is any clinic difference between right- versus left-sided lesions to make recommendations as to management.


2014 ◽  
Vol 60 (3) ◽  
pp. 122-124
Author(s):  
M. Gherghinescu ◽  
D. Popa ◽  
A. Panțiru ◽  
C. Russu ◽  
C. Roșca ◽  
...  

Abstract Background: Incisional hernias are important complications of abdominal surgery. Normally they are followed by the growth of the hernia sac and an increase of the abdominal wall defect with loss of domain of the herniated organs. Case report: We report a case of a 51 year old female, admitted in the 1st Surgical Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș with a large median reducible incisional hernia and a wall defect of 10/12 cm. The abdominoplasty was performed using the Oscar Ramirez technique, which consists of a longitudinal incision along the aponeurosis of the external oblique muscle, at approximately 1-2 cm from the external edge of the rectus abdominis. This procedure allows the abdominal wall closure. This case is part of a lot of 4 patients who received this treatment using the aforementioned procedure in the past 2 months. Postoperative recovery was favorable, bowel movements were present on the second day after the surgery, the subcutaneous drains were shortened on the fifth day and removed on the sixth. There were no immediate postoperative complications or up to a month after the surgery. The patient was discharged on the seventh day. Conclusions: This technique can be used alone in case of large abdominal wall defects, or prequeling an on-lay mesh procedure addressed to a weak abdominal wall, case in which the functional result is superior to a substitutional mesh.


2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Evangelos Falidas ◽  
Stavros Gourgiotis ◽  
Christina Goudeli ◽  
Stavros Mathioulakis ◽  
Konstantinos Vlachos ◽  
...  

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh.


Author(s):  
Stefan Bittmann

Omphalocele is one of the congenital abdominal wall defects and specifically refers to an umbilical ring defect in which the abdominal organs protrude in front of the abdominal wall in a thin sac or membrane. Such an abdominal wall defect develops around the third week of pregnancy due to the failure of adhesion between the embryonic lateral abdominal wall components.


Author(s):  
Rafael Calvão BARBUTO ◽  
Ivana DUVAL-ARAUJO ◽  
Sumara Marques BARRAL ◽  
Raphael Grossi ROCHA ◽  
Cristiane de Souza BECHARA ◽  
...  

Background : The use of alloplastic meshes has been historically contra-indicated in patients with infection. Aim : To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. Methods : Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. Results : More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. Conclusion : The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse.


2011 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Roel E. Genders ◽  
Paul P.G.M. Kouwenberg ◽  
Rob P. Bleichrodt

Repair of abdominal wall defects in the presence of contamination or infection is a significant problem. The loss of tissue warrants enforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive surgery. This paper presents a review of available literature of placement of an acellular human dermis to repair an abdominal fascia defect, in contaminated as well as in non-contaminated surgical fields. It is illustrated with a case report that describes the successful reconstruction of an infected abdominal wall defect with a human acellular dermis allograft. A systematic literature review was undertaken with searches performed in the Pubmed and Cochrane databases for the period up till March 2009, using the search terms <em>Alloderm</em> [Substance Name], <em>Hernia</em> [Mesh] and the key words <em>acellular dermis, acellular dermal matrix, human acellular dermal allograft </em>and <em>abdominal wall defect</em>. To assess methodological quality, each article was subjected to a modification of the methodological index for non-randomized studies (MINORS) according to Slim <em>et al.</em> Two items from the original index were not included because none of the studies selected had an unbiased assessment of the study end points and in none of the studies was a prospective calculation of the study size performed. Seventeen studies were included in the review. Data were extracted regarding study design, number of patients, surgical technique, followup period, contaminated or non-contaminated area of the fascia defect, mortality and morbidity (hemorrhage, seroma, wound dehiscence, infection) of the operative procedure, the longterm results (removal of the graft, reherniation and bulging) and level of evidencey. A total of 169 short-term complications and 151 longterm complications occurred after 643 surgical procedures reconstructing both contaminated and clean abdominal wall defects by implantation of an HADA. Human acellular dermal allograft seems to be a good alternative for autologous repair of contaminated or infected abdominal wall defects.


2009 ◽  
Vol 13 (1) ◽  
pp. 119-126 ◽  
Author(s):  
Chantal A. Vella ◽  
Diana Ontiveros ◽  
Raul Y. Zubia ◽  
Julia O. Bader

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Natasha T. Logsdon ◽  
Carla M. Gallo ◽  
Luciano Alves Favorito ◽  
Francisco J. Sampaio

AbstractAnalyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3–5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9–5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6–3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2–3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r2 = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.


1992 ◽  
Vol 13 (2) ◽  
pp. 107-118 ◽  
Author(s):  
Rina Alcalay

Latino women in California have less access to health care, particularly prenatal care, than any other ethnic group. This exploratory study identified perceptions about prenatal care needs, barriers to utilization of health services and common health behaviors during pregnancy among a sample of Mexican American women and a sample of prenatal care providers. The research used a combination of written questionnaires and focus-group discussions to gather data from a sample of sixty Mexican American community women, and a written questionnaire only to get information from a sample of forty providers. Results showed that providers perceived Mexican American women as doing better than non-Latino women regarding a series of health behaviors during pregnancy and as doing worse regarding another set of prenatal care behaviors. Results also showed that Mexican American pregnant teenagers are at particularly high risk regarding prenatal care due to a combination of structural and cultural factors. Acculturation was found to be an important factor affecting prenatal care beliefs and behaviors among this population. This relationship deserves further study. The influence of acculturation also needs to be considered in the design of prenatal care communication strategies with Mexican American women.


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