title: Outcomes in infants with prenatally diagnosed gastroschisis and planned preterm delivery.
abstract: BACKGROUND
  The timing and mode of delivery of pregnancies with prenatally diagnosed gastroschisis remains controversial.
  
  
  OBJECTIVE
  To evaluate the outcome of patients with gastroschisis managed during two time periods: 2006-2009 and 2010-2014, with planned elective cesarean delivery at 37 versus 35 gestational weeks (gw). A secondary aim was to analyze the outcome in relation to the gestational age at birth.
  
  
  METHODS
  Retrospective review of all cases with gastroschisis managed at our institution between 2006 and 2014.
  
  
  RESULTS
  Fifty-two patients were identified, 24 during the initial period, and 28 during the second. There were a significantly higher number of emergency cesarean deliveries in the first period. There were no differences between groups with regard to the use of preformed silo, need of parenteral nutrition or length of hospital stay. When analyzing the outcome in relation to the gw the patients actually were born, we observed that patients delivered between 35 and 36.9 gw were primary closed in 88.5% of cases, with shorter time on mechanical ventilation, parenteral nutrition and hospital stay.
  
  
  CONCLUSIONS
  Planned caesarian section at 35 completed gestational weeks for fetuses with prenatally diagnosed gastroschisis is safe. We observe the best outcome for patients born between 35 and 36.9 gw.
authors.affiliation: Department for Pediatric Surgery, Astrid Lindgren's Children's Hospital, Stockholm, Sweden. carmen.mesas.burgos@ki.se.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mesas Burgos
authors.affiliation: Department for Pediatric Surgery, Astrid Lindgren's Children's Hospital, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Svenningsson
authors.affiliation: Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Jenny Hammarqvist
authors.initials: JH
authors.lastname: Vejde
authors.affiliation: Department for Pediatric Surgery, Astrid Lindgren's Children's Hospital, Stockholm, Sweden.
authors.forename: Tina
authors.initials: T
authors.lastname: Granholm
authors.affiliation: Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Conner
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: Abdominal wall defects; Caesarean section; Colon atresia; Gastroschisis; Intestinal failure; Preterm delivery; Short bowel syndrome; Small bowel atresia