Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience
Background. This study aims to evaluate the experience of a tertiary health center on the timeliness of postnatal management in newborns with open neural tube defects (NTDs). Methods. This is a retrospective review of 38 neonates with NTDs who were treated surgically at a tertiary heal...
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Hacettepe University Institute of Child Health
2021-08-01
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| Series: | The Turkish Journal of Pediatrics |
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| Online Access: | https://turkjpediatr.org/article/view/347 |
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| author | Ayhan Pektaş Mehmet Gazi Boyacı Hilal Koyuncu Mine Kanat Pektaş Ahmet Afşin Kundak |
| author_facet | Ayhan Pektaş Mehmet Gazi Boyacı Hilal Koyuncu Mine Kanat Pektaş Ahmet Afşin Kundak |
| author_sort | Ayhan Pektaş |
| collection | DOAJ |
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Background. This study aims to evaluate the experience of a tertiary health center on the timeliness of postnatal management in newborns with open neural tube defects (NTDs).
Methods. This is a retrospective review of 38 neonates with NTDs who were treated surgically at a tertiary health care center between January 2009 and January 2019. Five neonates with genetic syndromes were excluded.
Results. Twenty-six neonates with NTD underwent surgery on the first postnatal day while 12 neonates with NTD had surgery after the first postnatal day. The reasons for the latency in operative treatment were the delay in the referral of the affected newborn from other health care centers (n=8) and the transient abnormalities in coagulation tests (n=4). Rural residence was significantly more frequent, gestational age at delivery was significantly lower, preterm delivery was significantly more frequent and prenatal diagnosis was significantly less frequent in neonates that underwent surgery for NTD repair after the first postnatal day (p=0.001, p=0.048, p=0.024 and p=0.003 respectively). Postoperative motor dysfunction was significantly more severe (p=0.002), postoperative complications were significantly more frequent (p=0.008), the reoperation and postoperative mortality rates were significantly higher (p=0.009 and p=0.048 respectively) and the duration of hospital stay was significantly longer (p=0.033) for the neonates who underwent surgery after the first postnatal day.
Conclusions. Our study appears to favor the early repair of NTD`s within the first 24 hours of life. Such an approach may reduce the risk of infectious and neurological complications significantly.
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| format | Article |
| id | doaj-art-c9c545bb0a1d4b13a8e097c780e55d5b |
| institution | DOAJ |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-c9c545bb0a1d4b13a8e097c780e55d5b2025-08-20T02:55:41ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212021-08-0163410.24953/turkjped.2021.04.016Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experienceAyhan Pektaş0Mehmet Gazi Boyacı1Hilal Koyuncu2Mine Kanat Pektaş3Ahmet Afşin Kundak4Departments of Pediatric Cardiology, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.Departments of Neurosurgery, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.Departments of Pediatrics, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.Departments of Obstetrics & Gynecology, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.Departments of Neonatology, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey. Background. This study aims to evaluate the experience of a tertiary health center on the timeliness of postnatal management in newborns with open neural tube defects (NTDs). Methods. This is a retrospective review of 38 neonates with NTDs who were treated surgically at a tertiary health care center between January 2009 and January 2019. Five neonates with genetic syndromes were excluded. Results. Twenty-six neonates with NTD underwent surgery on the first postnatal day while 12 neonates with NTD had surgery after the first postnatal day. The reasons for the latency in operative treatment were the delay in the referral of the affected newborn from other health care centers (n=8) and the transient abnormalities in coagulation tests (n=4). Rural residence was significantly more frequent, gestational age at delivery was significantly lower, preterm delivery was significantly more frequent and prenatal diagnosis was significantly less frequent in neonates that underwent surgery for NTD repair after the first postnatal day (p=0.001, p=0.048, p=0.024 and p=0.003 respectively). Postoperative motor dysfunction was significantly more severe (p=0.002), postoperative complications were significantly more frequent (p=0.008), the reoperation and postoperative mortality rates were significantly higher (p=0.009 and p=0.048 respectively) and the duration of hospital stay was significantly longer (p=0.033) for the neonates who underwent surgery after the first postnatal day. Conclusions. Our study appears to favor the early repair of NTD`s within the first 24 hours of life. Such an approach may reduce the risk of infectious and neurological complications significantly. https://turkjpediatr.org/article/view/347morbiditymortalityneural tube defectsoperative surgical procedures |
| spellingShingle | Ayhan Pektaş Mehmet Gazi Boyacı Hilal Koyuncu Mine Kanat Pektaş Ahmet Afşin Kundak Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience The Turkish Journal of Pediatrics morbidity mortality neural tube defects operative surgical procedures |
| title | Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience |
| title_full | Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience |
| title_fullStr | Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience |
| title_full_unstemmed | Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience |
| title_short | Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience |
| title_sort | timeliness of postnatal surgery in newborns with open neural tube defects a single center experience |
| topic | morbidity mortality neural tube defects operative surgical procedures |
| url | https://turkjpediatr.org/article/view/347 |
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