Gastroschisis: Overview of epidemiology and management trends

Published Date: 07th October 2016

Publication Authors: Pankaja S

​Introduction 

A rise in incidence of gastroschisis has been reported. We investigated the incidence in our unit. 

Methods 

In a retrospective series; maternal case notes of all gastroschisis patients diagnosed in utero at a single NHS centre over a 6-year period were reviewed (n = 14). 

Results 

Gastroschisis was diagnosed in 14 fetuses, i.e. 6 per 10 000 births (total number of births; n = 23 112). Forty-three percent (n = 6) of these mothers were primigravidae. Most (79%; n = 11) were <25 years of age and Caucasian (79%; n = 11); 50% (n = 7) were smokers. All cases were identified antenatally and had serial growth scans. At birth, six babies (43%) were <5th centile in weight. Half of the patients had a normal vaginal delivery (n = 7) while the remainder (n = 7) underwent caesarean section (CS). Indications for CS were fetal bradycardia (n = 1) and previous CS (n = 1). Gastroschisis with dilated bowel loops was the indication for grade 3 CS at 35/36 weeks for four patients. One patient had a CS at 37 weeks with gastroschisis the only documented reason. No adverse outcomes were seen in the babies born vaginally.

Conclusion 

Our study confirms that prevalence of gastroschisis is increasing. It is associated with young age and smoking. These babies are often small-for-gestational-age. Gastroschisis alone should not be an indication for CS as it does not improve outcome for neonates. Women can be reassured that if they labour there is a good chance of vaginal birth.

Pankaja, S; Simon, R; Sullivan, H. (2016). Gastroschisis: Overview of epidemiology and management trends . BJOG: An International Journal of Obstetrics and Gynaecology. 123 (Suppl 1), 81

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