Prenatal Diagnosis dan Penatalaksanaan Gastroskisis
Abstract
Gastroskisis merupakan defek kongenital yang terjadi pada dinding abdomen janin. Kejadian yang dilaporkan di seluruh dunia berkisar antara 4-5 per 10.000 kelahiran hidup. Mortalitas pada bayi yang lahir dengan gastroschisis telah menurun selama bertahun-tahun tetapi morbiditas masih tetap tinggi. Diperlukan prenatal diagnosis yang optimal agar proses melahirkan bisa dipersiapkan sebaik mungkin. Pada prenatal diagnosis dilakukan penilaian defek kongenital lainnya agar hasil klinis lebih baik dengan manajemen lebih awal, selain itu dilakukan juga penilaian untuk menentukan adanya kelainan kromosom atau tidak. Apabila kelainan tersebut bersifat isolated, maka hasil klinis akan lebih baik dibandingkan gastroschisis dengan kelainan kromosom. Metode persalinan dan waktu persalinan yang direkomendasikan yaitu pada usia kehamilan 37 minggu dengan metode sectio caesarea. Manajemen neonatal meliputi persalinan di fasilitas kesehatan tersier dan manajemen bedah paska kelahiran yaitu penutupan bedah primer, penutupan bertahap dengan silo, atau penutupan umbilikal tanpa jahitan.
Prenatal Diagnosis and Management of Gastroschisis
Abstract
Gastroskisis is a congenital defect that occurs in the fetal abdominal wall. Events reported throughout the world range from 4-5 per 10,000 live births. Mortality in infants born with Gastroskisis has declined over the years but morbidity is still high. An optimal prenatal diagnosis is needed so that the labor can be prepared as well as possible. Prenatal diagnosis is done by assessing other congenital defects so that clinical results are better with earlier management, in addition assessment is also done to determine whether there is a chromosome abnormality or not. If the abnormality is isolated, the clinical results will be better than Gastroskisis with chromosomal abnormalities. The recommended method of delivery and labor time is 37 weeks gestational age with the sectio caesarea method. Neonatal management includes delivery in tertiary health facilities and management of postnatal surgery namely primary surgical closure, staged reduction with silo and sutureless umbilical closure.
Key words: Congenital Defect, Gastroskisis, Prenatal Diagnosis
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DOI: http://dx.doi.org/10.24198/obgynia.v2i2.125
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