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Outcomes in infants with prenatally diagnosed gastroschisis and planned preterm delivery

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Abstract

Background

The timing and mode of delivery of pregnancies with prenatally diagnosed gastroschisis remains controversial.

Aim

To evaluate the outcome of patients with gastroschisis managed during two time periods: 2006–2009 and 2010–2014, with planned elective cesarean delivery at 37 versus 35 gestational weeks (gw). A secondary aim was to analyze the outcome in relation to the gestational age at birth.

Material and methods

Retrospective review of all cases with gastroschisis managed at our institution between 2006 and 2014.

Results

Fifty-two patients were identified, 24 during the initial period, and 28 during the second. There were a significantly higher number of emergency cesarean deliveries in the first period. There were no differences between groups with regard to the use of preformed silo, need of parenteral nutrition or length of hospital stay. When analyzing the outcome in relation to the gw the patients actually were born, we observed that patients delivered between 35 and 36.9 gw were primary closed in 88.5 % of cases, with shorter time on mechanical ventilation, parenteral nutrition and hospital stay.

Conclusion

Planned caesarian section at 35 completed gestational weeks for fetuses with prenatally diagnosed gastroschisis is safe. We observe the best outcome for patients born between 35 and 36.9 gw.

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Authors and Affiliations

  1. Department for Pediatric Surgery, Astrid Lindgren’s Children’s Hospital, Stockholm, Sweden

    Carmen Mesas Burgos, Anna Svenningsson & Tina Granholm

  2. Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden

    Jenny Hammarqvist Vejde & Peter Conner

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  1. Carmen Mesas Burgos
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  2. Anna Svenningsson
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Correspondence to Carmen Mesas Burgos.

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Mesas Burgos, C., Svenningsson, A., Vejde, J.H. et al. Outcomes in infants with prenatally diagnosed gastroschisis and planned preterm delivery. Pediatr Surg Int 31, 1047–1053 (2015). https://doi.org/10.1007/s00383-015-3795-8

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