GROWTH-RETARDATION IN PRENATALLY DIAGNOSED CASES OF GASTROSCHISIS

Gastroschisis is a rare congenital anomaly characterized by the hernia tion of fetal intestines directly through an abdominal wall defect. It is associated infrequently with chromosomal or other nonbowel defects and can be treated surgically after delivery, with survival rates rep orted to be between 87 and 100%. We reviewed 21 cases of prenatally di agnosed gastroschisis to ascertain the effect of fetal growth retardat ion on perinatal outcome. Ten of the 21 fetuses (48%) were identified prenatally as growth retarded, although only seven of these ten truly had birth weights less than the 10th percentile. Three additional fetu ses that had not been identified prenatally as growth retarded did, in fact, have birth weights less than the 10th percentile, for a total f requency of growth retardation at birth of 48% (10/21 fetuses). When c ompared to non-growth-retarded fetuses with gastroschisis, fetuses who were growth retarded, although more likely to have been delivered by emergency cesarean section, had shorter hospitalization times, were mo re likely to have undergone primary closure on the first day of life, and had fewer major complications. We conclude that growth retardation is common in fetuses with gastroschisis and the postnatal outcome in gastroschisis is not poorer for fetuses who are growth retarded.