Controversies in the management of gastroschisis: a study of 40 patients

Forty infants with gastroschisis were referred to two paediatric surgeons during a 13 year period. Overall survival was 90%. Nine patients were transferred in utero and 31 were referred postnatally. Birth weights, gestational ages, and Apgar scores were similar for both groups. Primary closure of th...

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Bibliographic Details
Published in:Archives of disease in childhood 1991-01, Vol.66 (1 Spec No), p.34-36
Main Authors: Stringer, M D, Brereton, R J, Wright, V M
Format: Article
Language:English
Subjects:
Abdominal Muscles - abnormalities
Abdominal Muscles - surgery
Birth defects
Cesarean Section
Congenital Abnormalities - mortality
Female
Humans
Incidence
Infant, Newborn
Infants (Newborn)
Labor, Obstetric
Mechanical ventilation
Newborn infants
Patient Transfer
Pediatrics
Pregnancy
Prenatal Diagnosis
Prognosis
Retrospective Studies
Surgery
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Summary:Forty infants with gastroschisis were referred to two paediatric surgeons during a 13 year period. Overall survival was 90%. Nine patients were transferred in utero and 31 were referred postnatally. Birth weights, gestational ages, and Apgar scores were similar for both groups. Primary closure of the defect was successfully achieved in seven (78%) patients in the prenatally transferred group compared with 17 (55%) in the postnatal group. Significantly less postoperative assisted ventilation, and a trend in favour of early discharge home, were noted after prenatal transfer. Problems arising during postnatal transfer may have contributed to these differences. No major differences resulting from the mode of delivery were identified. Patients treated by primary closure fared significantly better than those undergoing staged repairs with prosthetic material. Prospective randomised studies are required to confirm these findings.
ISSN:0003-9888
1468-2044
DOI:10.1136/adc.66.1_Spec_No.34