The timing of delivery of infants with gastroschisis influences outcome

Ergün, Orkan; Barksdale, Edward M.; Ergün, Fisun Şenuzun; Prosen, Tracy L.; Qureshi, Faisal; Reblock, Kim R.; Ford, Henri R.; Hackam, David J.

doi:10.1016/j.jpedsurg.2004.10.013

Cited by 94 publications

(63 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, prematurity and low birth weight seem to correlate with adverse outcome, such as higher occurrence of sepsis and longer time to full feeds and hospitalization period [1,10,16]. However, in our analysis low birth weight and preterm labor were not associated with adverse outcome.…”

Section: Discussioncontrasting

confidence: 73%

Factors determining outcome in gastroschisis: clinical experience over 18 years

Jager

Heij

2007

Pediatr Surg Int

View full text Add to dashboard Cite

Although the survival in gastroschisis has improved to more than 85%, serious morbidity with consequent long hospital stay is still very common. Alternative strategies such as planned early delivery and amniotic fluid exchange are being explored. In order to evaluate these approaches, adequate risk stratification of patients with gastroschisis is required. The aim of this study was to identify the risk factors associated with increased morbidity and mortality. A retrospective analysis of all patients with gastroschisis treated at our institution between 1988 and 2005 was conducted. Patients' data were collected from the files and compared for statistical significance with three outcome measures: (1) complicated post-operative course; (2) time to full enteral feeding (TFE); (3) length of hospital stay (LOS). SPSS was used for statistical analysis. Fifty-nine newborns with gastroschisis were admitted during the study period. Antenatal diagnosis was made in 40 cases (68%). Associated malformations (other than intestinal anomalies) were present in eight patients. One patient with trisomy 13 was excluded from the analysis. Ten patients (17%) had compromised bowel (atresia, severe ischaemia or a combination). Primary repair was successful in 47 (81%) and in 11 patients a silo was applied. Overall survival was 54/58 children (93%), four patients died. Complications associated with closure occurred in eight patients. Postoperative course was uncomplicated in 45 patients and complicated in 13. The RR for patients with compromised bowel to have a complicated post-operative course is 9 (95% CI 2-39) and the RR to die is 20 (95% CI 2-222) for these patients. Risk stratification of patients with gastroschisis appears possible based on the presence of compromised bowel before closure.

show abstract

Section: Discussioncontrasting

confidence: 73%

Factors determining outcome in gastroschisis: clinical experience over 18 years

Jager

Heij

2007

Pediatr Surg Int

View full text Add to dashboard Cite

show abstract

“…Some fetuses with certain birth defects have been scheduled for elective early delivery because of possible benefits. For example, early delivery of infants with gastroschisis might be associated with reduced morbidity, improved surgical outcomes, and reduced hospital length of stay; however, to date, the results are mixed [38][39][40]. Somewhat stronger associations between preterm birth and birth defects were noted for births delivered by Csection as compared to vaginal delivery, and this could be due in part to scheduled C-sections for pregnancies known to be affected by a defect.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Major Birth Defects and Preterm Birth

Honein¹,

Kirby

Meyer

et al. 2008

Matern Child Health J

114

View full text Add to dashboard Cite

Objective To evaluate the association between preterm birth and major birth defects by maternal and infant characteristics and specific types of birth defects. Study Design We pooled data for 1995-2000 from 13 states with population-based birth defects surveillance systems, representing about 30% of all U.S. births. Analyses were limited to singleton, live births from 24-44 weeks gestational age. Results Overall, birth defects were more than twice as common among preterm births (24-36 weeks) compared with term births (37-41 weeks gestation) (prevalence ratio [PR] = 2.65, 95% confidence interval [CI] 2.62-2.68), and approximately 8% of preterm births had a birth defect. Birth defects were over five times more likely among very preterm births (24-31 weeks gestation) compared with term births (PR = 5.25, 95% CI 5.15-5.35), with about 16% of very preterm births having a birth defect. Defects most strongly associated with very preterm birth included central nervous system defects (PR = 16.23, 95% CI 15.49-17.00) and cardiovascular defects (PR = 9.29, 95% CI 9.03-9.56). Conclusions Birth defects contribute to the occurrence of preterm birth. Research to identify shared causal pathways and risk factors could suggest appropriate interventions to reduce both preterm birth and birth defects.

show abstract

“…The recommended mode and timing of delivery remains a subject of debate [23][24][25][26] . Labor may be deleterious to the externalized bowel loops, and may entail the risk of membrane rupture and of infection.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors at birth of the severity of gastroschisis

Roessingh¹

2015

WJGP

View full text Add to dashboard Cite

The timing of delivery of infants with gastroschisis influences outcome

Cited by 94 publications

References 17 publications

Factors determining outcome in gastroschisis: clinical experience over 18 years

Factors determining outcome in gastroschisis: clinical experience over 18 years

The Association Between Major Birth Defects and Preterm Birth

Predictive factors at birth of the severity of gastroschisis

Contact Info

Product

Resources

About