THE ROLE OF ANTEPARTUM SURVEILLANCE IN THE MANAGEMENT OF GASTROSCHISIS

Objective: To evaluate the perinatal morbidity and mortality of fetuse s diagnosed with gastroschisis at our Fetal Diagnosis and Treatment Ce nter. Methods: A retrospective review of a regional prenatal diagnosti c center. Twenty-nine cases of gastroschisis which were diagnosed, man aged, delivered and had corrective surgeries through the Fetal Diagnos is and Treatment Center were identified from 1985 to 1994. Perinatal m orbidity and mortality were reviewed. Antepartum testing schemes were reviewed when available to determine whether morbidity or mortality co uld have potentially been prevented. Results: Meconium occurrence, int rauterine growth retardation (IUGR) and oligohydramnios complicated 79 %, 41% and 36% of the cases, respectively. The perinatal mortality of this series was 241/1000. Significant differences in perinatal mortali ty were noted when fetal testing was incorporated (200/1000 vs. 286/10 00, P less than or equal to 0.001). Conclusion: Gastroschisis is assoc iated with a high incidence of IUGR, meconium, oligohydramnios and hig h perinatal mortality. Antenatal testing appears to significantly lowe r perinatal mortality in pregnancies complicated by gastroschisis.