THE EFFECT OF MODE OF DELIVERY ON OUTCOME IN FETUSES WITH GASTROSCHISIS

The postoperative course in neonates with gastroschisis after successf ul surgical repair is complicated by prolonged ileus. Elective cesarea n section (CS) has been advocated to Limit damage to the bowel due to labor and compression in the narrow birth canal and to prevent retrogr ade infection. We reviewed the records of 58 infants with gastroschisi s treated between 1977 and 1993; 12 were delivered by CS for obstetric al reasons and 46 were delivered vaginally (V). Mortality was higher i n the CS group (V = 1/46, CS = 4/12). Both groups differed significant ly with respect to birth weight and gestational age; gestational age, however, had no influence on morbidity and mortality. Primary contamin ation was significantly lower in the CS group (V = 29/42, CS = 3/12). However, no difference was found regarding infectious complications. N o complications could be attributed directly to the mode of delivery. Since these data do not show any significant advantages of CS on morbi dity and mortality, we do not recommend CS for fetuses with gastroschi sis diagnosed prenatally.