Gastroschisis Challenges North and South: Challenges in Uganda

Kathryn E. Larusso, M.D.
Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada

Summary Slides: Challenges in Uganda

Challenges

  • Low priority because of poor prognosis
  • Lack of intensive care
  • No TPN
  • No central venous access and loss of peripheral IV access over time
  • Poor fluid management (only burettes for delivery of IVF and drugs)
  • No preformed silos

Key Intervention Measures

  • Urine bag sutured around defect at bedside with local anesthesia
  • IVF resuscitation using PIV access
  • Antibiotics, normothermia
  • NGT with aspiration q2h by mother
  • Breast-milk gauze
  • Daily reductions
  • Once passing stool, infant allowed to breastfeed as tolerated
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