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Eur J Pediatr Surg 2008; 18(1): 32-37
DOI: 10.1055/s-2007-965744
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Preliminary Report on Elective Preterm Delivery at 34 Weeks and Primary Abdominal Closure for the Management of Gastroschisis

A. Serra1 , G. Fitze1 , G. Kamin2 , J. Dinger3 , I. R. König4 , D. Roesner1
  • 1Department of Pediatric Surgery, University of Dresden, Dresden, Germany
  • 2Department of Gynecology and Obstetrics, University of Dresden, Dresden, Germany
  • 3Department of Pediatrics, University of Dresden, Dresden, Germany
  • 4Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
Further Information

Publication History

received July 12, 2007

accepted after revision August 21, 2007

Publication Date:
26 February 2008 (online)

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Abstract

Introduction: We aimed to critically evaluate elective preterm delivery and immediate abdominal wall closure and other techniques for the management of gastroschisis, hypothesizing that the advantages of an elective preterm delivery outweigh possible complications related to prematurity at birth. Patients and Methods: 13 gastroschisis patients were enrolled in the elective preterm delivery program (Group 1) since 1999. Patients were delivered by cesarean section in the 34th gestational week, with immediate primary closure of the defect. Data regarding parameters at and after birth were compared with a historical control group of 10 patients conventionally managed for gastroschisis in a similar period (1994 - 1999) (Group 2). The primary endpoints of this study were the initiation of oral feeding and the length of hospital stay. Results: There was a significantly faster initiation of oral feeding (p = 0.0012) and a shorter hospital stay (p = 0.0160) in Group 1. The postoperative outcome was excellent in all patients. Acute and late complications were fewer and less severe in Group 1 and none were related to prematurity. Conclusions: Elective preterm delivery appears to be an effective method for the management of gastroschisis, and a method whose advantages thus far have outweighed the possible complications due to prematurity.

Key words

gastroschisis - elective preterm delivery - primary abdominal closure

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Dr. M.D., Ph.D. Alexandre Serra

Department of Pediatric Surgery
University of Dresden

Fetscherstraße 74

01304 Dresden

Germany

Email: alexandre.serra@uniklinikum-dresden.de