Subscribe to RSS
DOI: 10.1055/s-2007-986692
Outcomes in Neonatal Gastroschisis: An Institutional Experience
Publication History
Publication Date:
14 September 2007 (online)
![](https://www.thieme-connect.de/media/ajp/200708/lookinside/thumbnails/10.1055-s-2007-986692-1.jpg)
ABSTRACT
We describe outcomes of 70 infants with gastroschisis admitted to our neonatal intensive care unit between 2001 and 2005. Demographic data and outcome measures including discharge or death, simple versus complex (intestinal atresia, perforation, bowel necrosis, or volvulus), length of stay, mechanical ventilation and total parenteral nutrition, commencement of enteral feeds and age at reaching full feeds, and number of episodes of bacteremia were evaluated. In our study, 72% of the patients (n = 58) were simple cases, 28% were complex, and 44% had a positive blood culture. Median length of stay was 43 and 116 days for simple and complex cases, respectively. Median age at commencement of enteral feeds was 19 and 44 days for simple and complex cases, respectively. Six (14%) infants with simple and 8 (50%) with complex gastroschisis required an assisted feeding device (gastrostomy) tube before discharge. We concluded that the type of gastroschisis (simple versus complex) is an important determinant of outcome, including time to start and get to full feeds, duration of parenteral nutrition, length of stay, and survival. Although it is not always possible to determine whether the defect is simple or complex by antenatal scans, this information will be valuable to families with infants with gastroschisis and should be made available as soon as possible.
KEYWORDS
Gastroschisis - outcomes - length of stay - bacteremia - mortality
REFERENCES
- 1 Abdullah F, Arnold M A, Nabaweesi R et al.. Gastroschisis in the United States 1988-2003: analysis and risk categorization of 4344 patients. J Perinatol. 2007; 27 50-55
- 2 Ledbetter D J. Gastroschisis and omphalocele. Surg Clin N Am. 2006; 86 249-260
- 3 Sharp M, Bulsara M, Gollow I, Pemberton P. Gastroschisis: early enteral feeds may improve outcome. J Paediatr Child Health. 2000; 36 472-476
- 4 Dimitriou G, Greenough A, Mantagos J S, Davenport M, Nicolaides K H. Morbidity in infants with antenatally-diagnosed anterior abdominal wall defects. Pediatr Surg Int. 2000; 16 404-407
- 5 Japaraj R P, Hockey R, Chan F Y. Gastroschisis: can prenatal sonography predict neonatal outcome?. Ultrasound Obstet Gynecol. 2003; 21 329-333
- 6 Piper H G, Jaksic T. The impact of prenatal bowel dilation on clinical outcomes in neonates with gastroschisis. J Pediatr Surg. 2006; 41 897-900
- 7 Vegunta R K, Wallace L J, Leonardi M R et al.. Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg. 2005; 40 528-534
- 8 Kitchanan S, Patole S K, Muller R, Whitehall J S. Neonatal outcome of gastroschisis and exomphalos: a 10-year review. J Paediatr Child Health. 2000; 36 428-430
- 9 Molik K A, Gingalewski C A, West K W et al.. Gastroschisis: a plea for risk categorization. J Pediatr Surg. 2001; 36 51-55
- 10 Curry J I, Lander A D, Stringer M D. BAPS Multicentre Research Committee. A multicenter, randomized, double-blind, placebo-controlled trial of the prokinetic agent erythromycin in the postoperative recovery of infants with gastroschisis. J Pediatr Surg. 2004; 39 565-569
- 11 Filston H C. Gastroschisis-primary fascial closure. The goal for optimal management. Ann Surg. 1983; 197 260-264
- 12 Shah R, Woolley M M. Gastroschisis and intestinal atresia. J Pediatr Surg. 1991; 26 788-790
Akshaya J VachharajaniM.D.
1 Children's Place
St. Louis, MO 63110