Preterm elective caesarean section and early enteral feeding in gastroschisis.

Abstract

AIMS:

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.

CONCLUSION:

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: I Reigstad, H Reigstad, T Kiserud, T Berstad
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 100 Issue 1 Pg. 71-4 (Jan 2011) ISSN: 1651-2227 [Electronic] Norway
• PMID: 21143293 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

Topics

• Cesarean Section (methods)
• Clinical Protocols
• Elective Surgical Procedures
• Enteral Nutrition (methods)
• Female
• Gastroschisis (mortality, therapy)
• Gestational Age
• Humans
• Infant, Newborn
• Length of Stay (statistics & numerical data)
• Male
• Pregnancy
• Premature Birth
• Retrospective Studies
• Survival Analysis
• Time Factors
• Treatment Outcome