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.
Keywords: Abdominal wall defects; Caesarean section; Colon atresia; Gastroschisis; Intestinal failure; Preterm delivery; Short bowel syndrome; Small bowel atresia.