11-Year Experience with Gastroschisis: Factors Affecting Mortality and Morbidity

The aim of the study was the evaluation of patients treated with a diagnosis of gastroschisis and to establish the factors which affected the morbidity and mortality. Twenty-nine patients, managed for gastroschisis during 2000-2010 were reviewed retrospectively. Patients were analysed in respect to gestational age, birth weight, associated anomalies, type of delivery, operative procedures, postoperative complications, total parenteral nutrition (TPN) related complications. The factors affecting mortality and morbidity were determined. Associated abnormalities were present in 24% of the patients. Eleven patients underwent elective reduction in the incubator (Bianchi procedure) without anaesthesia. Eight patients had delayed reduction with silo and ten patients had primary closure. Although the type of delivery had an effect on morbidity but not mortality, gestational age, birth weight, and the operative procedure performed had no effect on morbidity or mortality. Duration until tolerance of oral intake, and of TPN and hospitalization were found to be statistically significantly shorter in the group of babies delivered by caesarean section. The mortality of gastroschisis is reported to be decreasing with the development of antenatal care, neonatal intensive care and TPN. In our study the most important cause of mortality was the abdominal compartment syndrome and multi-organ failure in the early years. Long hospitalization periods and sepsis were the main causes of mortality in recent years.