Sonographic Features, Epidemiological Aspects and Neonatal Outcome of Fetuses with Gastroschisis

Abstract

Objective To identify epidemiological and prenatal sonographic factors in cases of fetal gastroschisis.

Design An observational study of 71 consecutive fetuses with antenatally diagnosed gastroschisis. Setting The Fetal Medicine Unit (FMU) at University College Hospital of London (UCLH)

Sample Seventy one fetuses with antanatally diagnosed gastroschisis referred to the FMU.

Main Outcome Measures Perinatal outcome including type of surgical repair and duration of 

infants' hospital stay.

Results The median maternal age in pregnancies complicated by gastroschisis was 24.8 years (range 17-36), The occurrence of vaginal delivery were 37 cases (66%), emergency caesarean section were 13 cases (23%), elective caesarean section were 6 cases (11%) and spontaneous preterm vaginal delivery were 11 cases (100%). Eighteen cases (26.9%) were of socio-economic class V, 22 (32.8%) were class IV, 23 (34.3%) were class III, 3 (4.5%) were class II and 1 (1.5%) was class I. Neonatal outcome was classified according to the complexity of the surgical repair and the length of hospital stay into good, fair and poor (Table 1). The presence of bowel dilatation > 15 mm on antanatal ultrasound scan (n= 35) was more likely to be associated with poor outcome (P < 0.005). The median duration of hospital stay was 44 days (range 1-124). Lower socio-economic status and younger maternal age were also associated with poor neonatal outcome (P < 0.005).

Conclusion Ultrasound findings and epidemiological factors such as the socio-economic status, maternal age and BMI should be taken into consideration in assessing the prognosis in cases of gastroschisis.