Modern obstetric management and outcome of infants with gastroschisis

Objective: To determine whether outcomes of infants with gastroschisis diff ered by mode or site of delivery, diagnostic method, or when maternal-fetal medicine consultation was given. Methods: Charts of 32 infants born at the University of Mississippi Medical Center or admitted to the neonatal intensive care unit between September 1 992 and June 1998 were reviewed for maternal demographic characteristics an d neonatal outcomes. Statistical analysis was done using Student t test, an alysis of variance, chi(2), and Kruskal-Wallis test with P < .05 considered statistically significant. Results: There were no statistically significant differences in neonatal ou tcomes by method or site of delivery, diagnostic method, or maternal-fetal medicine consultation before delivery. Infants delivered vaginally had high er Apgar scores at 1 and 5 minutes (9 versus 7 and 9 versus 8, respectively , P < .05). Vaginally delivered infants required more days of antibiotic th erapy than those delivered abdominally (10 versus 3 days, P < .05) but had a shorter interval to enteral feedings (15 versus 30 days, P < .05). Conclusion: Outcomes of infants with isolated gastroschisis were not signif icantly affected by method or site of delivery, diagnostic method, or mater nal-fetal surveillance. Although the findings of this investigation were la rgely negative and the statistical power limited due to the rarity of this fetal disruption, small series of cases of gastroschisis need to be analyze d to resolve current controversies surrounding optimal treatment of gastros chisis. (C) 1999 by The American College of Obstetricians and Gynecologists .