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Pediatric Surgery International

, Volume 26, Issue 9, pp 871–878 | Cite as

Gastroschisis: an update

  • Andrew J. A. HollandEmail author
  • Karen Walker
  • Nadia Badawi
Review Article

Abstract

Gastroschisis (GS) continues to increase in frequency, with several studies now reported an incidence of between 4 and 5 per 10,000 live births. The main risk factor would seem to be young maternal age, and it is in this group that the greatest increase has occurred. Whilst various geographical regions confer a higher risk, the impact of several other putative risk factors, including smoking and illicit drug use, may be less important than when first identified in early epidemiological studies. Over 90% of cases of GS will now be diagnosed on antenatal ultrasound, but its value in determining the need for early delivery remains unclear. There would appear no clear evidence for either routine early delivery or elective caesarean section for infants with antenatally diagnosed GS. Delivery at a centre with paediatric surgical facilities reduces the risk of subsequent morbidity and should represent the standard of care. The relative roles of primary closure, staged closure and ward reduction, with or without general anaesthesia, appear less clear with considerable variation between centres in both the use of these techniques and subsequent surgical outcomes. Survival rates continue to improve, with rates well in excess of 90% now routine. The limited long-term developmental data available would suggest that normal or near-normal outcomes may be expected although there remains a need for further studies.

Keywords

Gastroschisis Incidence Risk factors Antenatal diagnosis Treatment strategies Neurodevelopmental outcomes 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Andrew J. A. Holland
    • 1
    Email author
  • Karen Walker
    • 2
  • Nadia Badawi
    • 2
  1. 1.Douglas Cohen Department of Paediatric Surgery, The Children’s Hospital at Westmead, Sydney Medical SchoolThe University of SydneySydneyAustralia
  2. 2.Department of Neonatology, The Children’s Hospital at Westmead, Sydney Medical SchoolThe University of SydneyNSWAustralia

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