1007652?1327452428
Mark P Johnson, MD  
Male

Interests: Fetal diagnosis, fetal therapy
The Children’s Hospital of Philadelphia
Pediatric General Surgery
215-590-4510
Philadelphia, PA
My Posts
Apr 18, 2010 in the Surgery Expert Forum - 2
Omphaloceles are generally simple hernias of the bowel within the umbilical cord. However, some can be very large and result in large hernia sacs extending from the abdominal wall and contain the fetal liver, stomach and bowel. Simple omphaloceles where loops of bowel are within a hernia sac adjacent to the umbilical cord can be associated with chromosomal or...
Apr 18, 2010 in the Surgery Expert Forum - 1
Most babies with gastroschisis delivery vaginally, but must be watched VERY carefully during labor with fetal heart rated monitoring as some do not tolerate contractions during labor and need to be delivered by cesarean section before they become severely stressed that could make their management more complicated after delivery. You should deliver your baby a...
Feb 01, 2010 in the Surgery Expert Forum - 1
Abdominal scar tissue can certainly be associated with pain in pregnancy as the uterus and abdominal wall increase in size. It is doubtful that the mess in your abdominal wall caused you to go into preterm labor. However, because your daughter was delivered prematurely, you are at higher risk than other women who delivered at term for going into preterm labor...
Feb 01, 2010 in the Surgery Expert Forum - 1
The most common form of conjoined twins is called Thoracoomphalopagus (75% of cases) and refers to twins that are attached at the front of their chests and upper part of their abdomen to the level of where the umbilical cord inserts. They most often share a head normal common heart (75% of cases) that has multiple structural abnormalities of the pumping cham...
Feb 01, 2010 in the Surgery Expert Forum - 1
Gastroschisis is generally considered a sporadic occurrence meaning that the risk for future pregnancies is minimal (less than 1%). However, there are studies that suggest a some families carry a predisposition with a multifactorial-type of inheritance such that recurrence risks are between 4 and 5%. There is some recent evidence that suggest that taking 4-5...
Jan 16, 2010 in the Surgery Expert Forum - 2
Your baby has a serious complication of spina bifida. Severe ventriculomegaly (hydrocepahly) can result is very difficult deliveries because of head size (macrocephaly) and cause injury to the brain over time. In such cases, we generally coordinate and elective cesarean delivery when the baby reaches 35 weeks gestation so that the pediatric neurosurgeons can ...
Jan 16, 2010 in the Surgery Expert Forum - 1
We recommend vaginal delivery for babies with gastroschisis unless there is an obstetrical contraindication such as breech presentation. The process of vaginal delivery will not injure the bowel further, is safer for you and has a faster recovery time and actually has physiologic benefits to the baby as far as lung function goes. However, many babies with gas...
Jan 16, 2010 in the Surgery Expert Forum - 1
Baby may have focal femoral deficiency syndrome, but what you really need is a comprehensive evaluation and consultation with pediatric orthopedics. There are bone lengthening procedures available. If the baby has other abnormalities detected at time of consultation, then a clinical genetics evaluation may be suggested. As far as the prenatal ultrasounds go, ...
Jan 02, 2010 in the Surgery Expert Forum - 1
Sorry for the late response. Question is what type of abdominal defect is present. Such defects can range from umbilical cord hernias, to omphalocele, to giant liver containing omphaloceles, to severe body-stalk and limb body-wall malformations. Prognosis, evaluations, obstetrical and pediatric surgical management depends on the problem present, as does su...
Jan 02, 2010 in the Surgery Expert Forum - 1
Gastroschisis is a developmental abnormality of the abdominal wall that occurred during early development. There is no fetal therapy at present for this problem. Present recommendations are for good high risk prenatal care (keep all of your appointments), eliminate factors that might affect growth (smoking), and monitoring of the baby's growth, developme...