Document Detail


The importance of serial biophysical assessment of fetal wellbeing in gastroschisis.
MedLine Citation:
PMID:  1450139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review antenatal and intrapartum assessment of pregnancies complicated by gastroschisis. DESIGN: Retrospective descriptive study. SETTING: University College Hospital, London. SUBJECTS: 24 consecutive cases of gastroschisis between 1986 and 1991. RESULTS: The gestational age at sonographic diagnosis was 20.3 weeks (SD 6.77) and at birth was 36.5 weeks (SD 2.06). There were 21 live births, all with good surgical outcome. There were 16 vaginal deliveries and eight caesarean sections. The elective sections were for oligohydramnios and dilated bowel (1) and clinically suspected growth retardation (1); the intrapartum caesarean sections were for fetal distress (4) and premature breech presentation (2). There were six with dilated gut on ultrasound; one of these ended in a stillbirth. There was a significant association between gut dilatation and caesarean section for fetal distress (P = 0.004). There was also a significant association between meconium staining and fetal distress (P = 0.021). Of these babies, 46% were < or = third centile for corrected birth weight. CONCLUSIONS: While half of the babies with gastroschisis were small for gestational age at birth, reliable antenatal prediction of birth weight is difficult. Gut dilatation may be an indicator of either antenatal or intrapartum fetal distress, but does not correlate with poor neonatal surgical outcome. We suggest close antenatal surveillance of fetal wellbeing in all cases of gastroschisis because, in addition to growth retardation, many show some evidence of fetal distress and 12.5% end in stillbirth, even when appropriately grown.
Authors:
R A Crawford; G Ryan; V M Wright; C H Rodeck
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  99     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1993-01-06     Completed Date:  1993-01-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  899-902     Citation Subset:  AIM; IM    
Affiliation:
Department of Fetal Medicine, University College Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Muscles / abnormalities*
Abortion, Spontaneous / etiology
Amniotic Fluid / chemistry
Birth Weight
Cardiotocography
Female
Fetal Growth Retardation / etiology,  physiopathology
Heart Rate, Fetal
Humans
Labor, Induced
Pregnancy
Pregnancy Outcome
Retrospective Studies

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