IS SPECIALIST CENTER DELIVERY OF GASTROSCHISIS BENEFICIAL

This study aims to establish the usefulness of delivering neonates wit h gastroschisis in a regional obstetric and neonatal centre without th e facility of on site surgery. A retrospective analysis was performed on the notes of 43 consecutive neonates with gastroschisis referred to Birmingham Children's Hospital over a 10 year period. Two groups were compared: those delivered at the regional obstetric centre (n=9) and those delivered peripherally (n=34). Both groups underwent postnatal t ransfer. There were no significant differences with regard to gestatio nal age, birth weight, caesarean section rate, time to operation, and mortality. Primary closure rates were 89% for the regional centre grou p and 94% for the peripheral hospital group. Mean time to full enteral feeding was 24 days for the regional centre group and 23 days for tho se delivered peripherally. These data show that good results can be ac hieved with postnatal transfer. If on site surgery is not available, n eonatal services are adequate peripherally, and the transfer distance is not too great, then delivery in a regional obstetric centre with su bsequent postnatal transfer offers no advantage.