P10.11: Posnatal outcomes of fetuses with the prenatal diagnosis of gastroschisis in a reference service in Brazil

Abstract

Evaluate the posnatal outcomes of pregnancies with the prenatal diagnosis of gastroschisis. We conducted an observational and retrospective study, based on information contained in medical records of pregnant women with fetal gastroschisis born in the Hospital of the Federal University of São Paulo (UNIFESP-EPM) between January of 2009 and December of 2013. Gestational age, birthweight, delivery mode and indications, APGAR Score, pH of the umbilical cord, time between birth and surgery, number of surgeries, days in the neonatal ICU, neonatal complications, hospitalizations in childhood were evaluated. We analyzed data from 44 pregnant women of fetuses with gastroschisis. Mean maternal age was 21.2 years and 63% were primiparous. 6,8% of the fetuses had associated anomalies diagnosed by prenatal ultrasonography. The mean gestational age at birth was 36,1 weeks, and 60% of patients had birth below 36 weeks. Caesarean section was performed in 93,2% of cases. 59,1% of newborn infants were male and the mean weight at birth was 2366g (38,6% were above of 2500g, 36.4% between 2000 and 2500g, 20,5% between 1500 and 2000g, and 4,5% were below 1500g). The mean of the 1 min APGAR Score was 8 and the 5 min was 9, and 100% of the fetuses showed 5 min APGAR Socore > 7. The average umbilical cord pH was 7.35, and only 12.% had a pH below 7.2. The average days in the NICU was 52,7 days. 95.5% of newborns were operated on the first day of life e 63.6% underwent only surgery. 20.5% of children underwent bowel resection and 6.8% had short bowel syndrome. 59.1% of the newborns had infection during the neonatal period with positive blood culture and 22.7% had hospitalizations during childhood. 25% of the fetuses died (18.2% in the prenatal period, the neonatal period 45.4% and 36.4% during early childhood). The main cause of postnatal death was infection, accounting for 44.4% of deaths in this period. The newborns and children with gastroschisis diagnosed in prenatal period has high rate of complications and death.