PRETREATMENT OF GASTROSCHISIS WITH TRANSABDOMINAL AMNIOTIC-FLUID EXCHANGE

Background: Intestinal thickening in gastroschisis results from prolon ged exposure to amniotic fluid (AF). Experimental AF exchange has been shown to prevent intestinal thickening in gastroschisis. Case: A 25-y ear-old primigravida was referred at 24 weeks' gestation with a prenat al diagnosis of gastroschisis. Transabdominal AF exchange was performe d at 29 weeks. This pretreatment did not cause any complications and p revented intestinal thickening in our patient. Thus, we were able to p erform primary fascial closure with an intra-abdominal pressure less t han 5 mmHg. We began feeding the infant on the 5th day and discharged her on the 8th day. Conclusion: Evidence obtained from this initial ca se seems promising for the further application of the AF exchange for prevention of intestinal thickening in gastroschisis. (C) 1998 by The American College of Obstetricians and Gynecologists.