ELECTIVE CESAREAN-SECTION IMPROVES OUTCOMES OF NEONATES WITH GASTROSCHISIS

OBJECTIVE: Our objective was to compare neonatal postoperative morbidi ty for the neonate with prenatally diagnosed gastroschisis delivered v aginally with that for the perinate undergoing elective cesarean at or before the onset of labor. STUDY DESIGN: Retrospective maternal and n eonatal data were obtained by chart review on 22 neonates prenatally d iagnosed with gastroschisis who underwent operative closure of the ven tral wall defect between 1987 and 1991 at Loma Linda University Medica l Center. Perioperative data and postoperative courses were compared b etween 12 infants who underwent labor with vaginal delivery and 10 inf ants who were delivered by elective cesarean section at or before the onset of labor. RESULTS: Neonatal transports and significant bowel ede ma were more likely (p < 0.05) in the vaginal delivery group. The elec tive cesarean section infants had less sepsis (p < 0.05), fewer hospit al days (p < 0.01) and parenteral nutrition days (p < 0.01), and short er time to enteral feedings (p < 0.01). CONCLUSIONS: Elective cesarean section at or before the onset of labor may benefit the fetus with ga stroschisis, compared with undergoing labor and vaginal delivery.