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Postnatal Outcome of Fetuses With the Prenatal Diagnosis of Gastroschisis

Department of Radiology, Harvard Medical School, Brigham and Women's Hospital (S.M.D., C.B.B.), and Department of Surgery, Harvard Medical School, Children's Hospital (C.D.D., J.M.W.), Boston, Massachusetts

Address correspondence and reprint requests to Sara M. Durfee, MD, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.

Objective. To assess the postnatal outcome and complications that arise in infants with the prenatal diagnosis of gastroschisis. Methods. Prenatal sonograms with the diagnosis of gastroschisis were identified. Maternal age, indication for sonography, gestational age at diagnosis, other sonographic abnormalities, and postnatal outcome were recorded. Results. Twenty-six fetuses at 16 to 36 weeks' gestational age had gastroschisis diagnosed on sonography. In 5 cases, other fetal anomalies were identified, including hydronephrosis and asymmetric hydrocephalus. In 9 of 21 cases followed by serial prenatal sonography, bowel dilatation developed, prompting delivery in 2. Two of the 26 study fetuses were electively terminated. The remaining 24 were born live and had immediate repair of the gastroschisis after birth. Nineteen infants (79%) had postnatal complications, some with multisystem complications, including 3 deaths, 10 with gastrointestinal complications, 6 with infectious complications, and 6 with anomalies involving other systems (genitourinary, cardiac, central nervous system, and respiratory). Only 5 infants (21%) had completely uncomplicated postsurgical courses. Hospital stays for survivors ranged from 10 to 98 days (mean, 38 days; median, 33 days). Conclusions. Although reported survival rates are good for gastroschisis, the postoperative hospital stay is often lengthy, and complications are very common, especially those related to the gastrointestinal tract. Other anomalies are uncommon but not rare.

Key Words: gastroschisis • obstetric sonography • outcome

Abbreviations: MS-AFP, maternal serum -fetoprotein

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