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Published in: Pediatric Surgery International 4/2003

01-06-2003 | Original Article

Gastroschisis: determinants of neonatal outcome

Authors: S. J. Singh, A. Fraser, J. F. Leditschke, K. Spence, R. Kimble, J. Dalby-Payne, S. Baskaranathan, P. Barr, R. Halliday, N. Badawi, J. K. Peat, M. Glasson, D. Cass

Published in: Pediatric Surgery International | Issue 4/2003

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Abstract.

This retrospective study elicits information regarding the dependence of neonatal outcome in gastroschisis upon: (1) the mode of delivery, (2) place of birth, (3) time for birth to surgery, (4) method of closure, (5) time from operation to commencement of first enteral feeds. The neonatal intensive care database from five major tertiary centres was used to identify 181 neonates with gastroschisis from 1990 to 2000. There were 8 deaths. There were no significant differences in outcome for infants delivered vaginally (102) versus Caesarean section (79), those born near the tertiary centre (133) as compared to infants born away (48), ones operated within 7 hours (125) compared with those operated after 7 hours (56), with delayed closure (30) versus primary closure (151). Neonates fed within 10 days of operation (85) had significantly lower incidence of sepsis, duration of TPN and hospital stay when compared to those fed after 10 days (96). Early commencement of feeds decreases the incidence of sepsis, duration of total parenteral nutrition (TPN) and hospital stay. Place of delivery, mode of delivery, time to surgery and type of closure do not influence neonatal outcome.
Literature
1.
go back to reference Lancaster P, Hurst T, Huang J, Shafir E (1994) Congenital malformations Australia 1993 and 1994. Australian institute of health and welfare national perinatal statistics Unit. Birth Defects 2: 103–105 Lancaster P, Hurst T, Huang J, Shafir E (1994) Congenital malformations Australia 1993 and 1994. Australian institute of health and welfare national perinatal statistics Unit. Birth Defects 2: 103–105
2.
go back to reference Stringer MD, Brereton RJ, Wright VM (1991) Controversies in the management of Gastroschisis: a study of 40 patients. Arch Dis Child 66: 34–36 Stringer MD, Brereton RJ, Wright VM (1991) Controversies in the management of Gastroschisis: a study of 40 patients. Arch Dis Child 66: 34–36
3.
go back to reference Stoodley N, Sharma A, Noblett H, James D (1993) Influence of place of delivery on outcome in babies with Gastroschisis. Arch Dis Child 68: 321–323 Stoodley N, Sharma A, Noblett H, James D (1993) Influence of place of delivery on outcome in babies with Gastroschisis. Arch Dis Child 68: 321–323
4.
go back to reference Sakala EP, Erhard LN, White JJ (1993) Elective Caesarean section improves outcomes of neonates with Gastroschisis Am J Obs Gynecol 169: 1050–1053 Sakala EP, Erhard LN, White JJ (1993) Elective Caesarean section improves outcomes of neonates with Gastroschisis Am J Obs Gynecol 169: 1050–1053
5.
go back to reference Quirk JGJ, Fortney J, Collins HB, West J, Hassad SJ, Wagner C (1996) Outcome of newborns with gastroschisis: the effects of mode of delivery, site of delivery, and interval from birth to surgery. Am J Obs Gynecol 174: 1134–1138 Quirk JGJ, Fortney J, Collins HB, West J, Hassad SJ, Wagner C (1996) Outcome of newborns with gastroschisis: the effects of mode of delivery, site of delivery, and interval from birth to surgery. Am J Obs Gynecol 174: 1134–1138
6.
go back to reference Novotny DA, Klein RL, Boeckman CR (1993) Gastroschisis: an 18-year review. J Pediatr Surg 28: 650–652 Novotny DA, Klein RL, Boeckman CR (1993) Gastroschisis: an 18-year review. J Pediatr Surg 28: 650–652
7.
go back to reference Nicholls G, Upadhyaya V, Gornall P, Buick RG, Corkery JJ (1993) Is specialist centre delivery of Gastroschisis beneficial? Arch Dis Child 69: 71–72 Nicholls G, Upadhyaya V, Gornall P, Buick RG, Corkery JJ (1993) Is specialist centre delivery of Gastroschisis beneficial? Arch Dis Child 69: 71–72
8.
go back to reference Moretti M, Khoury A, Rodriquez J, Lobe T, Shaver D, Sibai B (1990) The effect of mode of delivery on the perinatal outcome in fetuses with abdominal wall defects. Am J Obs Gynecol 163: 833–838 Moretti M, Khoury A, Rodriquez J, Lobe T, Shaver D, Sibai B (1990) The effect of mode of delivery on the perinatal outcome in fetuses with abdominal wall defects. Am J Obs Gynecol 163: 833–838
9.
go back to reference Lewis DF, Towers CV, Garite TJ, Jackson DN, Nageotte MP, Major CA (1990) Fetal Gastroschisis and omphalocele: is Caesarean section the best mode of delivery? Am J Obs Gynecol 163: 773–775 Lewis DF, Towers CV, Garite TJ, Jackson DN, Nageotte MP, Major CA (1990) Fetal Gastroschisis and omphalocele: is Caesarean section the best mode of delivery? Am J Obs Gynecol 163: 773–775
10.
go back to reference Lenke RR, Hatch EI Jr (1986) Fetal Gastroschisis: a preliminary report advocating the use of Caesarean section. Obs Gynecol 67: 395–398 Lenke RR, Hatch EI Jr (1986) Fetal Gastroschisis: a preliminary report advocating the use of Caesarean section. Obs Gynecol 67: 395–398
11.
go back to reference Heydanus R, Raats MA, Tibboel D, Los FJ, Wladimiroff JW (1980) Prenatal diagnosis of fetal abdominal wall defects: a retrospective analysis of 44 cases. Prenatal Diagnosis 16: 411–417 Heydanus R, Raats MA, Tibboel D, Los FJ, Wladimiroff JW (1980) Prenatal diagnosis of fetal abdominal wall defects: a retrospective analysis of 44 cases. Prenatal Diagnosis 16: 411–417
12.
go back to reference Fitzsimmons J, Nyberg DA, Cyr DR, Hatch E (1988) Perinatal management of Gastroschisis. Obs Gynecol 71: 910–913 Fitzsimmons J, Nyberg DA, Cyr DR, Hatch E (1988) Perinatal management of Gastroschisis. Obs Gynecol 71: 910–913
13.
go back to reference Fasching G, Mayr J, Sauer J (1996) The effect of mode of delivery on outcome in fetuses with Gastroschisis. Pediatr Surg Int 11: 100–102 Fasching G, Mayr J, Sauer J (1996) The effect of mode of delivery on outcome in fetuses with Gastroschisis. Pediatr Surg Int 11: 100–102
14.
go back to reference Di Lorenzo M, Yazbeck S, Ducharme JC (1987) Gastroschisis: a 15-year experience. J Pediatr Surg 22: 710–712 Di Lorenzo M, Yazbeck S, Ducharme JC (1987) Gastroschisis: a 15-year experience. J Pediatr Surg 22: 710–712
15.
go back to reference Coughlin JP, Drucker DE, Jewell MR, Evans MJ, Klein MD (1993) Delivery room repair of Gastroschisis. Surgery 114: 822–826 Coughlin JP, Drucker DE, Jewell MR, Evans MJ, Klein MD (1993) Delivery room repair of Gastroschisis. Surgery 114: 822–826
16.
go back to reference Shah R, Woolley MM (1991) Gastroschisis and intestinal atresia. J Pediatr Surg 26: 788–790 Shah R, Woolley MM (1991) Gastroschisis and intestinal atresia. J Pediatr Surg 26: 788–790
17.
go back to reference Fonkalsrud EW (1980) Selective repair of neonatal Gastroschisis based on degree of visceroabdominal disproportion. Ann Surg 191: 139–144 Fonkalsrud EW (1980) Selective repair of neonatal Gastroschisis based on degree of visceroabdominal disproportion. Ann Surg 191: 139–144
18.
go back to reference Hagberg S, Hokegard KH, Rubenson A, Sillen U (1988) Prenatally diagnosed Gastroschisis – a preliminary report advocating the use of elective caesarean section. Zeitschrift fur Kinderchirurgie 43: 419–421 Hagberg S, Hokegard KH, Rubenson A, Sillen U (1988) Prenatally diagnosed Gastroschisis – a preliminary report advocating the use of elective caesarean section. Zeitschrift fur Kinderchirurgie 43: 419–421
19.
go back to reference Swift RI, Singh MP, Ziderman DA, Silverman M, Elder MA, Elder MG (1992) A new regime in the management of Gastroschisis. J Pediatr Surg 27: 61–63 Swift RI, Singh MP, Ziderman DA, Silverman M, Elder MA, Elder MG (1992) A new regime in the management of Gastroschisis. J Pediatr Surg 27: 61–63
20.
go back to reference Sipes SL, Weiner CP, Sipes DR, Grant SS, Williamson RA (1990) Gastroschisis and omphalocele: does either antenatal diagnosis or route of delivery make a difference in perinatal outcome? Obs Gynecol 76: 195–199 Sipes SL, Weiner CP, Sipes DR, Grant SS, Williamson RA (1990) Gastroschisis and omphalocele: does either antenatal diagnosis or route of delivery make a difference in perinatal outcome? Obs Gynecol 76: 195–199
21.
go back to reference Novotny DA, Klein RL, Boeckman CR (1993) Gastroschisis: an 18-year review. J Pediatr Surg 28: 650–652 Novotny DA, Klein RL, Boeckman CR (1993) Gastroschisis: an 18-year review. J Pediatr Surg 28: 650–652
22.
go back to reference Meizner I, Bar-Ziv J (1986) Prenatal ultrasonic diagnosis of anterior abdominal wall defects. Eur J Obs Gynecol Reproduct Biol 22: 217–224 Meizner I, Bar-Ziv J (1986) Prenatal ultrasonic diagnosis of anterior abdominal wall defects. Eur J Obs Gynecol Reproduct Biol 22: 217–224
23.
go back to reference Kirk EP, Wah RM (1983) Obstetric management of the fetus with omphalocele or Gastroschisis: a review and report of one hundred twelve cases. Am J Obs Gynecol 146: 512–518 Kirk EP, Wah RM (1983) Obstetric management of the fetus with omphalocele or Gastroschisis: a review and report of one hundred twelve cases. Am J Obs Gynecol 146: 512–518
24.
go back to reference Davidson JM, Johnson TRJ, Rigdon DT, Thompson BH (1984) Gastroschisis and omphalocele: prenatal diagnosis and perinatal management. Prenatal Diagnosis 4: 355–363 Davidson JM, Johnson TRJ, Rigdon DT, Thompson BH (1984) Gastroschisis and omphalocele: prenatal diagnosis and perinatal management. Prenatal Diagnosis 4: 355–363
25.
go back to reference Tawil KA, Gillam GL (1995) Gastroschisis: 13 years' experience at RCH Melbourne. J Paediatr Child Health 31: 553–556 Tawil KA, Gillam GL (1995) Gastroschisis: 13 years' experience at RCH Melbourne. J Paediatr Child Health 31: 553–556
26.
go back to reference Swift RI, Singh MP, Ziderman DA, Silverman M, Elder MA, Elder MG (1992) A new regime in the management of Gastroschisis. Journal of Pediatric Surgery 27: 61–63 Swift RI, Singh MP, Ziderman DA, Silverman M, Elder MA, Elder MG (1992) A new regime in the management of Gastroschisis. Journal of Pediatric Surgery 27: 61–63
27.
go back to reference Ein SH, Rubin SZ (1980) Gastroschisis: primary closure or Silon pouch. J Pediatr Surg 15: 549–552 Ein SH, Rubin SZ (1980) Gastroschisis: primary closure or Silon pouch. J Pediatr Surg 15: 549–552
28.
go back to reference Stringer MD, Brereton RJ, Wright VM (1991) Controversies in the management of Gastroschisis: a study of 40 patients. Arch Dis Child 66: 34–36 Stringer MD, Brereton RJ, Wright VM (1991) Controversies in the management of Gastroschisis: a study of 40 patients. Arch Dis Child 66: 34–36
29.
go back to reference Schwartz MZ, Tyson KR, Milliorn K, Lobe TE (1983) Staged reduction using a Silastic sac is the treatment of choice for large congenital abdominal wall defects. J Pediatr Surg 18: 713–719 Schwartz MZ, Tyson KR, Milliorn K, Lobe TE (1983) Staged reduction using a Silastic sac is the treatment of choice for large congenital abdominal wall defects. J Pediatr Surg 18: 713–719
30.
go back to reference Filston HC (1983) Gastroschisis – primary fascial closure. The goal for optimal management. Ann Surg 197: 260–264 Filston HC (1983) Gastroschisis – primary fascial closure. The goal for optimal management. Ann Surg 197: 260–264
31.
go back to reference Denmark SM, Georgeson KE (1983) Primary closure Gastroschisis Facilitation with postoperative muscle paralysis. Arch Surg 118: 66–68 Denmark SM, Georgeson KE (1983) Primary closure Gastroschisis Facilitation with postoperative muscle paralysis. Arch Surg 118: 66–68
32.
go back to reference Canty TG, Collins DL (1983) Primary fascial closure in infants with Gastroschisis and omphalocele: a superior approach. J Pediatr Surg 18: 707–712 Canty TG, Collins DL (1983) Primary fascial closure in infants with Gastroschisis and omphalocele: a superior approach. J Pediatr Surg 18: 707–712
33.
go back to reference Bower RJ, Bell MJ, Ternberg JL, Cobb ML (1982) Ventilatory support and primary closure of Gastroschisis. Surgery 91: 52–55 Bower RJ, Bell MJ, Ternberg JL, Cobb ML (1982) Ventilatory support and primary closure of Gastroschisis. Surgery 91: 52–55
34.
go back to reference Irving IM (1990) Umbilical Abnormalities. In: I Lister I, Irving IM (eds) Neonatal surgery. Butterworths, London, pp 376–402 Irving IM (1990) Umbilical Abnormalities. In: I Lister I, Irving IM (eds) Neonatal surgery. Butterworths, London, pp 376–402
35.
go back to reference Driver CP, Bruce J, Bianchi A, Doig CM, Dickson AP, Bowen J (2000) The Contemporary Outcome of Gastroschisis. J Pediatr Surg 35: 1719–1723 Driver CP, Bruce J, Bianchi A, Doig CM, Dickson AP, Bowen J (2000) The Contemporary Outcome of Gastroschisis. J Pediatr Surg 35: 1719–1723
36.
go back to reference Pierro A, Van Saene HK, Donnell SC, Hughes J, Ewan C, Nunn AJ, Lloyd a DA (1996) Microbial translocation in neonates and infants receiving long-term parenteral nutrition. Arch Surg 131: 176–179 Pierro A, Van Saene HK, Donnell SC, Hughes J, Ewan C, Nunn AJ, Lloyd a DA (1996) Microbial translocation in neonates and infants receiving long-term parenteral nutrition. Arch Surg 131: 176–179
37.
go back to reference Bastian L, Weimann A (1999) Practical aspects of early enteral feeding. Anaesthesiologie und Reanimation 24: 95–100 Bastian L, Weimann A (1999) Practical aspects of early enteral feeding. Anaesthesiologie und Reanimation 24: 95–100
38.
go back to reference Olejnik J (1998) All-in-one parenteral nutrition and enteral nutrition – experience and risks in surgical clinical practice [Slovak]. Rozhledy V Chirurgii 77: 555–558 Olejnik J (1998) All-in-one parenteral nutrition and enteral nutrition – experience and risks in surgical clinical practice [Slovak]. Rozhledy V Chirurgii 77: 555–558
39.
go back to reference Tomomasa T, Kuroume T (1994) Developmental Physiology. In: Hyman PE (ed) Pediatric gastronitestinal motility disorders. Academy professional information services, Inc, New York, pp 1–12 Tomomasa T, Kuroume T (1994) Developmental Physiology. In: Hyman PE (ed) Pediatric gastronitestinal motility disorders. Academy professional information services, Inc, New York, pp 1–12
40.
go back to reference Liang J, CO E, Zhang M, Pineda J, Chen JD (1998) Development of gastric slow waves in preterm infants measured by electrogastrography. Am J Physiol 274: G503–G508 Liang J, CO E, Zhang M, Pineda J, Chen JD (1998) Development of gastric slow waves in preterm infants measured by electrogastrography. Am J Physiol 274: G503–G508
41.
go back to reference Tawil Y, Berseth CL (1996) Gestational and postnatal maturation of duodenal motor responses to intragastric feeding. J Pediatrics 129: 374–381 Tawil Y, Berseth CL (1996) Gestational and postnatal maturation of duodenal motor responses to intragastric feeding. J Pediatrics 129: 374–381
42.
go back to reference Berseth CL (1989) Gestational evolution of small intestine motility in preterm and term infants. J Pediatr 115: 646–651 Berseth CL (1989) Gestational evolution of small intestine motility in preterm and term infants. J Pediatr 115: 646–651
43.
go back to reference Berseth CL (1992) Effect of early feeding on maturation of the preterm infant's small intestine. J Pediatr 120: 947–953 Berseth CL (1992) Effect of early feeding on maturation of the preterm infant's small intestine. J Pediatr 120: 947–953
44.
go back to reference Newell SJ (2000) Enteral feeding of the micropremie. CI Pernatol 27: 221–234 Newell SJ (2000) Enteral feeding of the micropremie. CI Pernatol 27: 221–234
Metadata
Title
Gastroschisis: determinants of neonatal outcome
Authors
S. J. Singh
A. Fraser
J. F. Leditschke
K. Spence
R. Kimble
J. Dalby-Payne
S. Baskaranathan
P. Barr
R. Halliday
N. Badawi
J. K. Peat
M. Glasson
D. Cass
Publication date
01-06-2003
Publisher
Springer-Verlag
Published in
Pediatric Surgery International / Issue 4/2003
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-002-0886-0

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