Remarks about the prognosis in case of antenatal diagnosis of gastroschisis.
We report our experience of 15 cases of gastroschisis which occurred between 1981 and 1993. All but one were diagnosed antenatally by ultrasound between 16 and 32 weeks of pregnancy. We made a termination of the pregnancy in 3 cases, for multiple malformations in 2 cases and one case of very early premature rupture of the membranes (PROM). When checked (11 cases), the karyotype was normal. We made a cesarean section in 11 cases: the indication was a complication for 6 (fetal distress, PROM, polyhydramnios, large dilatation of the gut). We noted growth retardation in 7 newborns and prematurity in 5/12 (mean gestational age of 36.8 weeks). The preoperative study of the gut noted 5 cases with intestinal damage and one case of complete necrosis of the gut. The global prognosis is not as good as usual, with a perinatal mortality of 41.6% (5/12). We discuss this latter point and examine the literature.
Poulain
P
P
Department of Obstetrics and Gynecology, CHRU Rennes, France.
Milon
J
J
Frémont
B
B
Proudhon
J F
JF
Odent
S
S
Babut
J M
JM
Le Marec
B
B
Grall
J Y
JY
Giraud
J R
JR
D000009:Abdominal Muscles / Q000002:abnormalities* / Q000601:surgery; D000649:Amniocentesis; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000235:genetics; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D007621:Karyotyping; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal