Outcome of fetuses with gastroschisis after modification of prenatal management strategies

Purpose: Several studies have been performed to evaluate prenatal predictors to improve the outcome of fetuses with gastrochisis. There are no standards in prenatal care since there are different guidelines. In our study we evaluated 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 compared 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: No 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 be observed. Regarding 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 close observation of fetuses with gastroschisis by sonographic monitoring of the small bowel diameter and the wall thickness.