The outcome and analysis of 40 cases of fetal gastroschisis

OBJECTIVE: This collaborative retrospective study was undertaken at Royal Medical Services Hospital, Amman, Jordan, between 1993 through to 2000. Its purpose was to assess the difference in terms of morbidity and mortality in neonates with gastroschisis delivered by cesarean section versus vaginal delivery.

METHODS: The records of all neonates born with gastroschisis (n=40, 26 females, 14 males) from 1993-2000 were analyzed. The mode of delivery was noted. Those babies delivered by cesarean section (n=22) were labelled group one, while those delivered vaginally (n=18) were labelled group 2. The mean maternal age was 26.45 ± 5.97 and 28.30 ± 4.22 years for groups one and 2 (P<0.05). Statistical analysis was carried out using standard deviation (SD), Fisher's exact test and Mann-Whitney U test.

RESULTS: The mean gestational age at diagnosis was 17.59 ± 1.58 for group one, and 17.95 ± 1.44 weeks for group 2 (P>0.05). The mean gestational age at cesarean section was 36.04 ± 1.02, and for vaginal delivery, 38.40 ± 1.10 (P>0.05). The mean maternal age was 26.45 ± 5.97 for group one, and 28.30 ± 4.22 years for group 2 (P< 0.05). The mean birth weight was 2.39 ± 0.39 kg for group one, and 3.10 ± 0.20 for group 2 (P< 0.05). Surgical repair was immediate after delivery and the mean neonatal age was 41.04 ± 6.40 minutes for both groups. The mean days of stay at hospital were 24.26 ± 8.75 for group one, and 34.20 ± 7.30 days for group 2 (P< 0.05).

CONCLUSION: Our study demonstrated that complications and morbidity were less in the cesarean section group compared to the vaginal delivery group. Immediate surgery for the neonate, in either group, was performed either by primary or secondary closure. However, a large multicenter, prospective randomised study is needed to ascertain the suitable route for delivery in gastroschisis fetuses.