Elective cesarean section improves outcomes of neonates with gastroschisis.
OBJECTIVE
Our objective was to compare neonatal postoperative morbidity for the neonate with prenatally diagnosed gastroschisis delivered vaginally with that for the perinate undergoing elective cesarean at or before the onset of labor.


METHODS
Retrospective maternal and neonatal data were obtained by chart review on 22 neonates prenatally diagnosed with gastroschisis who underwent operative closure of the ventral wall defect between 1987 and 1991 at Loma Linda University Medical Center. Perioperative data and postoperative courses were compared between 12 infants who underwent labor with vaginal delivery and 10 infants who were delivered by elective cesarean section at or before the onset of labor.


RESULTS
Neonatal transports and significant bowel edema were more likely (p < 0.05) in the vaginal delivery group. The elective cesarean section infants had less sepsis (p < 0.05), fewer hospital days (p < 0.01) and parenteral nutrition days (p < 0.01), and shorter time to enteral feedings (p < 0.01).


CONCLUSIONS
Elective cesarean section at or before the onset of labor may benefit the fetus with gastroschisis, compared with undergoing labor and vaginal delivery.
Sakala
E P
EP
Department of Gynecology and Obstetrics, Loma Linda University Medical Center, California 92350.
Erhard
L N
LN
White
J J
JJ
D000009:Abdominal Muscles / Q000002:abnormalities*; D000328:Adult; D002585:Cesarean Section; D016009:Chi-Square Distribution; D004750:Enteral Nutrition; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D007422:Intestines / Q000601:surgery; D007902:Length of Stay; D007744:Obstetric Labor Complications; D010288:Parenteral Nutrition; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000209:etiology; D014946:Wound Infection / Q000209:etiology