Перспективи внутрішньоутробного лікування запальних змін евентрованих органів при гастрошизисі у плодів (огляд літератури)

Abstract

Gastroschisis (GS) - is one of the most severe defects of newborns, which is characterized by congenital eventration of the abdominal organs outside the anterior abdominal wall into the amniotic fluid, due to a through defect of the anterior abdominal wall. The defect is adjacent to the normal, unaltered umbilical cord, usually to the right of the umbilicus, the umbilical ring is split, the eventrated organs are not covered by embryonic membranes or their remains. The frequency of gastroschisis is 0.31-4.72 per 10,000 births. Although, with the development of modern surgical approaches over the past 15 years, the mortality of newborns with gastroschisisis dynamically decreasing, however, this pathology remains a significant problem in neonatal and pediatric surgery, as it requires early surgery, associated with a significant risk of disability in children due to short bowel syndrome, abdominal cancer and recurrent esophageal disease, adhesive intestinal obstruction, etc. Purpose - to analyze, according to the literature, the prospects for the use of cellular technologies for the in utero treatment of inflammatory changes in the enteric organs in fetal GS in experimental conditions. The main reason for the unsatisfactory results of GS treatment is the pathological changes of the eventrated organs and their consequences. Therefore one of the ways to reduce mortality in GS is intrauterine treatment and the prevention of inflammatory changes of the eventrated organs in the fetuses. Modern regenerative medicine offers several new approaches for the treatment of fetal malformations, including the use of cell technology. Stem cells, from various sources, are one of the alternative therapies that can inhibit inflammatory processes in tissues, activate endogenous reparative mechanisms, and, ultimately, together with the implementation of preventive measures, reduce perinatal mortality and disability. The availability of domestic cell drugs, the development of technologies for their transplantation, and methods of delivery of pregnant women with GS in the fetus, with proven clinical efficacy, will significantly improve the comprehensive treatment of patients with congenital malformations, which is significant social and economic importance. Therefore, the study of regenerative potential and assessment of the prospects for the use of stem cells in obstetrics and perinatal medicine from various sources is of great scientific and practical interest. No conflict of interests was declared by the authors.