Gastroschisis treatment: what are the causes of high morbidity and mortality rates?

• Published in: Chirurgia (Bucharest, Romania : 1990) Vol. 108; no. 4; pp. 516 - 520
• Main Authors: Tarcă, E, Aprodu, S G
• Format: Journal Article
• Language: English
• Published: Romania 01-07-2013
• Subjects: Abnormalities, Multiple - diagnosis; Abnormalities, Multiple - epidemiology; Abnormalities, Multiple - mortality; Abnormalities, Multiple - surgery; Female; Gastroschisis - diagnosis; Gastroschisis - epidemiology; Gastroschisis - mortality; Gastroschisis - surgery; Gestational Age; Humans; Infant, Newborn; Length of Stay; Male; Morbidity; Polyethylene; Prenatal Diagnosis - statistics & numerical data; Reconstructive Surgical Procedures - adverse effects; Reconstructive Surgical Procedures - methods; Retrospective Studies; Risk Factors; Romania - epidemiology; Surgical Mesh; Survival Rate; Treatment Outcome; Umbilical Cord - transplantation; Romania
• ISSN: 1221-9118

Gastroschisis is one of the most common birth defects of the anterior abdominal wall, in recent decades being witnessed a significant increase in the survival of children with such a condition. This study aims to discover the causes of the increased perinatal morbidity and mortality rates from gastroschisis in our country.
Retrospective study on 54 infants with gastroschisis. Patient data were statistically processed and the demographic characteristics, antenatal diagnosis, presence of associated anomalies, method of surgical treatment, postoperative complications, number of hospital stay days and survival rate were analysed.
Most demographic data and associated malformation rate in the study patients are in agreement with the data in the literature, except for prenatal diagnosis rate (16.7% vs 68- 88%), rapid hospital arrival and surgery (6.8 vs 4.3 hours), and the worst, the high rate of infections (68.5%) and hence mortality rate (63% vs. 6-7%).
Although the therapeutic approach in our clinic complies with the international trend, the mortality rate is still very high, its main cause in the study group proving to be prolonged sepsis and multiple organ failure, probably favored by the low rate of antenatal diagnosis leading to delay in the appropriate surgical management.