Cirrhosis and operative trauma: determining when care is futile

s from the First Annual Baylor Scott and White Surgery Research Day 318 was that maternal preeclampsia independently increases necrotizing enterocolitis (NEC) risk in newborns. Th e database of all births at our institution from 2008 to 2011 (n = 9993) was retrospectively reviewed after institutional review board approval. Multiple mother and baby variables, including maternal age, race, parity, mode of delivery, gestational age, birth weight, sex, and Apgar score, were included in the analysis. Babies born to mothers with preeclampsia (n = 1368) were compared with the control group of non-preeclamptic mothers (n = 8625). Babies with birth weights <10th percentile for gestational age were classifi ed as small-for-gestational-age (SGA). Statistics were performed using Pearson’s chi-square test. Th e incidence of NEC was 1.5% in the control group (n = 126) and 4.6% in the preeclampsia group (n = 63) (P < 0.001). A higher percentage of babies in the preeclampsia group were preterm <37 weeks gestational age (14.5% in control vs 41.4% in preeclampsia, P < 0.001) and SGA (6.3% in control vs 10.2% in preeclampsia, P < 0.001). Within the preterm population, 9.0% of the control babies and 10.8% of the preeclampsia babies developed NEC (P = 0.25). Th e eff ect of preeclampsia was dramatic in the SGA group, where 1.5% of controls developed NEC compared with 13.6% of preeclampsia babies (P < 0.001). We conclude that preeclampsia is an independent risk factor for development of NEC in babies with intrauterine growth restriction, given the observed 10-fold odds increase. Abnormal placentation results in the proinfl ammatory condition that characterizes maternal preeclampsia and often leads to fetal hypoxia, which manifests as growth restriction. Th is combination of maternal systemic infl ammatory response and fetal hypoxia can prime the fetal immune system in favor of the proinfl ammatory phenotype and reduced immune regulation in utero. Aff ected newborns are thus predisposed to development of systemic infl ammatory diseases such as NEC at birth. Effects of native nephrectomy on blood pressure in patients with autosomal dominant polycystic kidney disease after renal