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Gastroschisis and pain relief during silo reduction:effectiveness of Midazolam versus Paracetamol and Sucrose - Dissertation Example

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Gastroschisis is found in infants with a congenital defect in the anterior abdominal wall (Torfs et al, 1996), essentially a type of congenital hernia. The defect is in the form of a hole which arises during development in the womb…
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Gastroschisis and pain relief during silo reduction:effectiveness of Midazolam versus Paracetamol and Sucrose
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Download file to see previous pages Gastroschisis is found in infants with a congenital defect in the anterior abdominal wall (Torfs et al, 1996), essentially a type of congenital hernia. The defect is in the form of a hole which arises during development in the womb. From this hole, the bowel commonly escapes and can being to develop outside the abdomen (Allen & Wrenn, 1969). The size of the hole is usually small, around 4cm (Feldcamp et al, 2007;Yoshioka et al, 2004) and is most commonly to the right of the join between the umbilical cord and the outer stomach (Yoshioka et al, 2004). The prevalence of gastroschisis is fairly high (around 1 in every 7000-10000 births, depending on several factors [Hougland et al, 2005]) and, combining this with the generally small size of the legion, the problem is usually fairly easily fixed after birth (Loane et al, 2007). The causes of gastroschisis are currently unknown (Laughon et al, 2003) but there are a few theories in development. For example, the inhalation of paint fumes or similar during pregnancy can lead to gastroschisis (Snyder, 1999). Women who bear the children of more than one man are more likely to have children with the condition also (Thompson et al, 2002). Gastroschisis is commonly found in children of low birth weight (Snyder, 1999) and as such many of the causes of this have been suggested as possible causes, such as young maternal age, smoking or drug use during pregnancy or complications such as infection during the carriage (Loane et al, 2007). ...
Gastroschisis is commonly found in children of low birth weight (Snyder, 1999) and as such many of the causes of this have been suggested as possible causes, such as young maternal age, smoking or drug use during pregnancy or complications such as infection during the carriage (Loane et al, 2007). There are also genetic reasons for gastroschisis occurrence. The inheritance of this condition is autosomal recessive, meaning that it is not sex-linked and both parents must carry the mutation (Hwang & Kousseff, 2004). The environmental causes above may also lead to a genetic gastroschisis in that they can cause sporadic mutation leading to the condition (Yang et al, 1992). There are several ways in which the condition is thought to develop. These are as follows: There may be a rupture of the amniotic ring which causes a herniation of the bowel (Langer et al, 1993); There may be an abnormal folding of the body wall which causes the ventral wall to develop a defect, causing the hole through which the bowel can escape and develop (Feldkamp et al, 1997); There is a failure to incorporate the yolk sac during development (Langer et al, 1993); There is an abnormal development of either umbilical vein which causes a weakening of the umbilical link to the body wall and thus the characteristic hole (Tibboel et al 1986); And a failure of the mesoderm to develop correctly (Wilson & Johnson, 2004). Again, there are many hypotheses and none of these have been conclusively proven, nor may the cause be the same in all cases of gastroschisis. Diagnosis of Gastroschisis One of the main ways of diagnosing this condition is by prenatal ultrasound (Contro et al, 2010). The ...Download file to see next pages Read More
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