title: Gastroschisis: determinants of neonatal outcome.
abstract: This retrospective study elicits information regarding the dependence of neonatal outcome in gastroschisis upon: (1) the mode of delivery, (2) place of birth, (3) time for birth to surgery, (4) method of closure, (5) time from operation to commencement of first enteral feeds. The neonatal intensive care database from five major tertiary centres was used to identify 181 neonates with gastroschisis from 1990 to 2000. There were 8 deaths. There were no significant differences in outcome for infants delivered vaginally (102) versus Caesarean section (79), those born near the tertiary centre (133) as compared to infants born away (48), ones operated within 7 hours (125) compared with those operated after 7 hours (56), with delayed closure (30) versus primary closure (151). Neonates fed within 10 days of operation (85) had significantly lower incidence of sepsis, duration of TPN and hospital stay when compared to those fed after 10 days (96). Early commencement of feeds decreases the incidence of sepsis, duration of total parenteral nutrition (TPN) and hospital stay. Place of delivery, mode of delivery, time to surgery and type of closure do not influence neonatal outcome.
authors.affiliation: Consultant Paediatric Surgeon, Department of Paediatric Surgery, University Hospital, Queen's Medical Centre, Nottingham, NG7 2UH, UK. shailinder@aol.com
authors.forename: S J
authors.initials: SJ
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Fraser
authors.forename: J F
authors.initials: JF
authors.lastname: Leditschke
authors.forename: K
authors.initials: K
authors.lastname: Spence
authors.forename: R
authors.initials: R
authors.lastname: Kimble
authors.forename: J
authors.initials: J
authors.lastname: Dalby-Payne
authors.forename: S
authors.initials: S
authors.lastname: Baskaranathan
authors.forename: P
authors.initials: P
authors.lastname: Barr
authors.forename: R
authors.initials: R
authors.lastname: Halliday
authors.forename: N
authors.initials: N
authors.lastname: Badawi
authors.forename: J K
authors.initials: JK
authors.lastname: Peat
authors.forename: M
authors.initials: M
authors.lastname: Glasson
authors.forename: D
authors.initials: D
authors.lastname: Cass
mesh_terms: D036861:Delivery, Obstetric; D005260:Female; D020139:Gastroschisis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D010289:Parenteral Nutrition, Total; D012189:Retrospective Studies; D016896:Treatment Outcome