Chapters authored
Gastroschisis: Prenatal Diagnosis and Outcome
The purpose of this retrospective cohort study was to investigate and identify prenatal predictors of perinatal outcomes of gastroschisis. Antenatal data included extra-abdominal bowel dilatation (EABD) and intra-abdominal bowel dilatation (IABD). Perinatal data included gestational age, sex, and birth weight. Surgical data included presence of intestinal atresia, necrosis, perforation, strictures, and method of closure. Outcome data included duration of mechanical ventilation and total parenteral nutrition, pseudoobstruction, sepsis, reoperations, length of hospital stay, and mortality rates. Results were analyzed in 65 patients. EABD was documented in 55 patients with no significant difference between simple and complex gastroschisis group. In 27 patients (in 32% of simple and 73% of complex cases), IABD persisted until the last ultrasound scan. Simple gastroschisis group had a shorter hospital stay, shorter ventilation support duration, less bowel pseudoobstruction, less need for reoperation, and received less parenteral nutrition. The most frequent extraintestinal complication was sepsis. The only factor that has been shown to predict poorer outcomes of gastroschisis is the presence of complex gastroschisis. Current available evidence suggests that antenatal bowel dilatation is not associated with increased risk of adverse perinatal outcome in infants with gastroschisis. Also, the absence of bowel dilatation cannot fully exclude complex patients.
Part of the book: Congenital Anomalies