Gastroschisis: what is the average gestational age of spontaneous delivery?
OBJECTIVE
To consolidate what is known about pregnancies complicated by fetal gastroschisis through analysis of one of the largest series yet reported and to define the average gestational age of spontaneous delivery.


METHODS
From 1980 to 2001, 159 pregnancies complicated by fetal gastroschisis were identified at a tertiary care center. Gestational age at delivery, birth weight, preterm delivery rate, and maternal age were compared to the 2001 general population statistics. Patients with pregnancies complicated by gastroschisis who went into spontaneous labor (n = 86) were subdivided into 2 groups based on gestational age (< 37 weeks and > or = 37 weeks). Operative delivery rates for nonreassuring fetal status and Apgar scores were assessed.


RESULTS
Gastroschisis occurred more often in younger mothers (< 21 years) (42% vs 7.3%), was more frequently associated with preterm labor and delivery (28% vs 6%), and was associated with more low-birth-weight babies (36% vs 10%). The mean gestational age at spontaneous labor was 36.6 weeks. In those patients who labored spontaneously, there were no significant differences in the operative delivery rates for fetal distress; however, there was a trend to lower Apgar scores in babies born at 37 weeks or more.


CONCLUSIONS
Our data provide a framework for further studies to determine the optimal timing and mode of delivery for fetuses with gastroschisis.
Lausman
Andrea Y
AY
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
Langer
Jacob C
JC
Tai
Melissa
M
Seaward
P Gareth R
PG
Windrim
Rory C
RC
Kelly
Edmond N
EN
Ryan
Greg
G
D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000401:mortality; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013997:Time Factors; D016216:Ultrasonography, Prenatal