Literature DB >> 29417204

The influence of gestational age, mode of delivery and abdominal wall closure method on the surgical outcome of neonates with uncomplicated gastroschisis.

Maria V Fraga1, Pablo Laje2, William H Peranteau1, Holly L Hedrick1, Nahla Khalek1, Juliana S Gebb1, Julie S Moldenhauer1, Mark P Johnson1, Alan W Flake1, N Scott Adzick1.   

Abstract

AIM OF THE STUDY: To evaluate if gestational age (GA), mode of delivery and abdominal wall closure method influence outcomes in uncomplicated gastroschisis (GTC).
METHODS: Retrospective review of NICU admissions for gastroschisis, August 2008-July 2016. Primary outcomes were: time to start enteral feeds (on-EF), time to discontinue parenteral nutrition (off-PN), and length of stay (LOS). MAIN
RESULTS: A total of 200 patients with GTC were admitted to our NICU. Patients initially operated elsewhere (n = 13) were excluded. Patients with medical/surgical complications (n = 62) were analyzed separately. The study included 125 cases of uncomplicated GTC. There were no statistically significant differences in the outcomes of patients born late preterm (34 0/7-36 6/7; n = 70) and term (n = 40): on-EF 19 (5-54) versus 17 (7-34) days (p = 0.29), off-PN 32 (12-101) versus 30 (16-52) days (p = 0.46) and LOS 40 (18-137) versus 37 (21-67) days (p = 0.29), respectively. Patients born before 34 weeks GA (n = 15) had significantly longer on-EF, off-PN and LOS times compared to late preterm patients: 26 (12-50) days (p = 0.01), 41 (20-105) days (p = 0.04) and 62 (34-150) days (p < 0.01), respectively. There were no significant differences in outcomes between patients delivered by C-section (n = 62) and patients delivered vaginally (n = 63): on-EF 20 (5-50) versus 19 (7-54) days (p = 0.72), off-PN 32 (12-78) versus 33 (15-105) days (p = 0.83), LOS 42 (18-150) versus 41 (18-139) days (p = 0.68), respectively. There were significant differences in outcomes between patients who underwent primary reduction (n = 37) and patients who had a silo (88): on-EF 15 (5-37) versus 22 (6-54) days (p < 0.01), off-PN 28 (12-52) versus 34 (15-105) days (p = 0.04), LOS 36 (18-72) versus 44 (21-150) days (p = 0.04), respectively.
CONCLUSION: In our experience, late preterm delivery did not affect outcomes compared to term delivery in uncomplicated GTC. Outcomes were also not influenced by the mode of delivery. Patients who underwent primary reduction had better outcomes than patients who underwent silo placement.

Entities:  

Keywords:  Cesarean section; Gastroschisis; Preterm delivery; Primary reduction

Mesh:

Year:  2018        PMID: 29417204     DOI: 10.1007/s00383-018-4233-5

Source DB:  PubMed          Journal:  Pediatr Surg Int        ISSN: 0179-0358            Impact factor:   1.827


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Authors:  Helen Carnaghan; David Baud; Eveline Lapidus-Krol; Greg Ryan; Prakesh S Shah; Agostino Pierro; Simon Eaton
Journal:  J Pediatr Surg       Date:  2016-02-11       Impact factor: 2.545

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Journal:  Paediatr Neonatal Pain       Date:  2021-08-05

4.  What is the main factor in predicting the morbidity and mortality in patients with gastroschisis: delivery time, delivery mode, closure method, or the type of gastroschisis (simple or complex)?

Authors:  Mustafa Behram; Süleyman Cemil Oğlak; Seyithan Özaydın; Sema Süzen Çaypınar; İlker Gönen; Şeyhmus Tunç; Yusuf Başkıran; İsmail Özdemir
Journal:  Turk J Med Sci       Date:  2021-06-28       Impact factor: 0.973

5.  Outcome and management in neonates with gastroschisis in the third millennium-a single-centre observational study.

Authors:  Lotta Räsänen; Helene Engstrand Lilja
Journal:  Eur J Pediatr       Date:  2022-02-28       Impact factor: 3.860

  5 in total

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