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Arch Gynecol Obstet. 2016 Aug;294(2):239-43. doi: 10.1007/s00404-015-3961-1. Epub 2015 Nov 16.

Outcome of fetuses with gastroschisis after modification of prenatal management strategies : Prenatal management and outcome of gastroschisis.

Author information

1
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. AnjaBauseler@gmx.de.
2
Department of Pediatric Surgery, University Hospital of Münster, Münster, Germany.
3
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
4
Department of Fetal Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany.
5
Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany.
6
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. schmitzr@ukmuenster.de.

Abstract

PURPOSE:

To improve the outcome of fetuses with gastrochisis several studies evaluated prenatal predictors. But there are different guidelines established and therefore the prenatal care is not standardized. With our study we wanted to evaluate the outcome of fetuses with gastroschisis after modification of prenatal management strategies at the Department of Obstetrics and Gynecology of the University Hospital Münster.

METHODS:

In this explorative retrospective study of 39 fetuses with gastroschisis, we compare the clinical outcome between two management groups. In the first group (group 1, n = 14) prenatal indication for delivery was confirmed by a subjective evaluation of the small bowel diameter and the wall thickness without established cut-off values for these parameters. In the second group (group 2, n = 25) certain limits for the small bowel diameter (25 mm) and the wall thickness (2.5 mm) were used for fetal surveillance.

RESULTS:

Noticeable differences between the two groups regarding birth weight, weight centile, arterial pH, small bowel diameter, wall thickness, adverse bowel condition and re-operations could not be observed. In group 2, delivery was earlier (p = 0.011), and a lower rate of prenatal complications was observed (p = 0.016).

CONCLUSION:

To avoid adverse prenatal complications we recommend the observation of fetuses with gastroschisis by sonographic monitoring of the small bowel diameter and the wall thickness.

KEYWORDS:

Gastroschisis; Prenatal diagnosis; Prenatal management; Small bowel; Ultrasound

PMID:
26573013
DOI:
10.1007/s00404-015-3961-1
[Indexed for MEDLINE]

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