A cohort study investigating the mode of delivery of labours induced because of gastroschisis

Abstract

We hypothesise that in labours induced for gastroschisis, fewer caesarean sections are performed than in labours induced for other indications at the same gestation. If labour does not occur spontaneously before 38 weeks in uncomplicated cases of gastroschisis, labour is induced at our hospital. Cases of gastroschisis from January 1997 to October 2002 were identified using our anomaly database and cross-referenced with the Ciconia Maternity Information System (CMIS). Cases induced were matched for gestation and parity in a ratio of 1 : 3 with controls induced for all other reasons (CMIS did not indicate the reason for induction). Ninety-eight cases of gastroschisis were identified. Five women were delivered by elective caesarean section. Thirty-seven women laboured spontaneously, of whom two had an emergency caesarean section and one had an instrumental vaginal delivery. Forty-nine women were induced and these were matched with 147 controls. Thirty-four of the study group were nulliparous. The average gestation was 37 weeks (range: 34–38 weeks). The odds of requiring a caesarean section was significantly less in the induced gastroschisis group compared with the control group 1 (2%) vs. 22 (15%) (OR 0.12, 0.02–0.90). Six (12.2%) instrumental vaginal deliveries were performed in the gastroschisis group compared with 19 (13.0%) in the control group. We were unable to include seven cases of gastroschisis because of insufficient data on the CMIS database.