The fetus with gastroschisis: Impact of route of delivery and prenatal ultrasonography

A. M. Adra, H. J. Landy, J. Nahmias, O. Gomez-Marin

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

OBJECTIVES: Our purpose was (1) to assess the influence of delivery route on neonatal outcome in fetuses with gastroschisis and (2) to correlate ultrasonographic appearance of fetal bowel with immediate postnatal outcome. STUDY DESIGN: Forty-seven cases (1986 to 1994) were reviewed; three abortions and two stillbirths were excluded. Ultrasonographic appearance of fetal bowel (small bowel dilatation >10 mm) was evaluated in 27 cases. RESULTS: Twenty- six infants (61.9%) were delivered vaginally and 16 (38.1%) by cesarean section (11 elective, 5 in labor). Delivery route was not significantly associated with indicators of neonatal outcome (rate of primary closure, postoperative complications, days of parenteral nutrition, days to oral feeding, hospital days, or mortality). When ultrasonographic appearance of fetal bowel was correlated with outcome, fetuses with prenatally dilated bowel had significantly more bowel edema at birth (p = 0.038), longer operative time (p = 0.013), and higher overall rate of postoperative complications (p = 0.037). CONCLUSIONS: (1) Elective cesarean delivery does not improve neonatal outcome in infants with gastroschisis. (2) Abnormal ultrasonographic appearance of fetal bowel is associated with a more difficult repair and a higher overall incidence of postoperative complications.

Original languageEnglish (US)
Pages (from-to)540-546
Number of pages7
JournalAmerican journal of obstetrics and gynecology
Volume174
Issue number2
DOIs
StatePublished - Jan 1 1996

Keywords

  • fetal bowel
  • Gastroschisis
  • neonatal outcome
  • route of delivery

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

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