title: Preterm elective caesarean section and early enteral feeding in gastroschisis.
abstract: OBJECTIVE
  To evaluate the effect of elective caesarean section (CS) before term and early enteral nutrition on length of parenteral nutrition and hospital stay in infants with gastroschisis.
  
  
  METHODS
  Retrospective review of all infants with gastroschisis treated in a regional level III hospital from 1993 to 2008. During 1993-97, there was no established standard for management of pregnancy or delivery while a protocol on close foetal monitoring and early elective CS was adhered to for 1998-2008. Introduction of human milk on the first day after complete closure of the abdominal wall and rapid increase was the policy during the whole period.
  
  
  RESULTS
  With early elective CS, no foetal deaths occurred after 28-week gestational age (GA). Ten infants were born during the first period and 20 during the second period at a median GA (range) of 36.5 (34-40) and 35 (34-37) weeks (p = 0.013). Seven and 20, respectively, were born by CS. Median (range) days before full enteral feeds and hospital stay were 11.5 (7-39) and 13.0 (7-46) (p = 0.85), and 17.5 (12-36) and 22.5 (13-195) (p = 0.67), respectively. One child died of volvulus after discharge.
  
  
  CONCLUSIONS
  Close surveillance of pregnancy, elective preterm caesarean section, early surgery and active approach to primary closure and early enteral feeds appears to be a safe and effective line of management in gastroschisis.
authors.affiliation: Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Reigstad
authors.forename: H
authors.initials: H
authors.lastname: Reigstad
authors.forename: T
authors.initials: T
authors.lastname: Kiserud
authors.forename: T
authors.initials: T
authors.lastname: Berstad
mesh_terms: D002585:Cesarean Section / Q000379:methods*; D002985:Clinical Protocols; D017558:Elective Surgical Procedures; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D020139:Gastroschisis / Q000401:mortality / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011247:Pregnancy; D047928:Premature Birth; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome