Gastroschisis: A Review of Management and Outcomes.

Published

Journal Article (Review)

We performed an evidence-based review of the obstetrical management of gastroschisis. Gastroschisis is an abdominal wall defect, which has increased in frequency in recent decades. There is variation of prevalence by ethnicity and several known maternal risk factors. Herniated intestinal loops lacking a covering membrane can be identified with prenatal ultrasonography, and maternal serum α-fetoprotein level is commonly elevated. Because of the increased risk for growth restriction, amniotic fluid abnormalities, and fetal demise, antenatal testing is generally recommended. While many studies have aimed to identify antenatal predictors of neonatal outcome, accurate prognosis remains challenging. Delivery by 37 weeks appears reasonable, with cesarean delivery reserved for obstetric indications. Postnatal surgical management includes primary surgical closure, staged reduction with silo, or sutureless umbilical closure. Overall prognosis is good with low long-term morbidity in the majority of cases, but approximately 15% of cases are very complex with complicated hospital course, extensive intestinal loss, and early childhood death.

Full Text

Duke Authors

Cited Authors

  • O'Connell, RV; Dotters-Katz, SK; Kuller, JA; Strauss, RA

Published Date

  • September 2016

Published In

Volume / Issue

  • 71 / 9

Start / End Page

  • 537 - 544

PubMed ID

  • 27640608

Pubmed Central ID

  • 27640608

Electronic International Standard Serial Number (EISSN)

  • 1533-9866

Digital Object Identifier (DOI)

  • 10.1097/OGX.0000000000000344

Language

  • eng

Conference Location

  • United States