BIOCHEMICAL MARKERS OF STRESS, PAIN AND INTESTINAL INFLAMMATION IN THE UMBILICAL CORD BLOOD OF NEWBORNS WITH GASTROSCHISIS

Abstract

Gastroschisis is an abdominal wall defect with evisceration of the abdominal organs, into the amniotic fluid, without peritoneal membrane covering the organs. The incidence has increased in the last decades, ranging from 4 to 5 per 10,000 live births, with an increase of 6% every 2 years, in the last 10 years. Although the outcome of gastroschisis is good, this malformation is associated with significant perinatal morbidity and mortality. In gastroschisis the prevalence of fetal death is seven times greater than the general population, with increasing risk at each week of gestation after 32 weeks. Studies, not specific but, including also fetuses with gastroschisis showed that the fetus is capable to produce hormonal response in situation of stress. This study aims to extend this theory to fetuses with gastroschisis, once they have the abdominal organs into the amniotic fluid which may cause pain/stress, in addition to correlate the findings with pre and post-natal data. Therefore, in the present study it will be examined the levels of biochemical markers of stress, pain and inflammation in umbilical cord of 42 newborn with gastroschisis and 42 newborns without malformations. The biochemical markers will also be compared with fetal pain expression examined by 3D-4D ultrasound, and with herniated organs aspect on ultrasound and antenatal cardiotocography parameters, as well as the bowel aspect at birth. The results may help tosuggest the participation of the herniated organs in the fetal pain and stress with influence in the fetal and neonatal prognosis. (AU)