Prenatal diagnosis of gastroschisis and obstetric and perinatal outcome

Abstract

OBJECTIVE: To describe the characteristics and postoperative results of cases of gastroschisis treated at Conjunto Hospitalar de Sorocaba. METHODS: A retrospective study of 17 medical records of newborns with gastroschisis evaluated and operated by the Service of Pediatric Surgery from January 2004 to December 2008. It was analyzed the association among prenatal diagnosis of gastroschisis and parity, gestational age, birth weight, sex of newborn, hospital of birth and interval birth-surgery. The statistical analysis was performed by the tests T Student and Fisher Exact Test. RESULTS: The mean maternal age was 20.4 ± 3.55 years. Of the 17 medical records analyzed, ten patients had a prenatal diagnosis of gastroschisis and nine were primiparous. The interval from birth to surgery was more than 4 hours in nine newborns; the minimum was 1 hour and the maximum 120 hours. There was no evidence of the prevalence of sex among newborns. The Apgar in the first and fifth minutes, the gestational age and birth weight was higher in those without prenatal diagnosis. Eight of the 17 patients died, sepsis was the most common cause. All infants with prenatal diagnosis had the birth in a tertiary service and in most cases it was decided to caesarean section. Of the four infants who had no prenatal diagnosis, three died. CONCLUSION: The prenatal diagnosis of gastroschisis favors the adequate prenatal care and attendance in a tertiary hospital. This allows a faster surgical approach and results in improvement in mortality rates.