Prenatally diagnosed gastroschisis: a case for preterm delivery?

Abstract

The successful surgical closure of gastroschisis is invariably followed by a prolonged ileus. Early delivery of infants with prenatally diagnosed gastroschisis has been advocated as a method of limiting the intestinal damage that occurs in utero. This study examines 47 infants with gastroschisis. The mean gestational age of the infants was 37.5 weeks, although there was no policy of induction of premature labour. The mortality for the series was 4% (2 deaths). The mean duration of post-operative ileus was 14.1 days and the mean duration of hospital stay was 38.4 days. There was no correlation between gestational age and duration of ileus or hospital stay. Analysing infants born at 36 weeks' gestation as a separate group also failed to show statistically significant differences for duration of ileus or hospital stay. As gestational age does not correlate with time taken for intestinal function to recover, elective preterm delivery of the infant with prenatally diagnosed gastroschisis is not recommended. Delivery by caesarean section conferred no benefit in this study.