Gastroschisis: a systematic review of diagnosis, prognosis and treatment

Abstract

Objectives

The present systematic review aims to investigate the diagnosis, prognosis, delivery assistance, pregnancy results and postnatal management in gastroschisis.

Study design

The following data sources were evaluated: The CINAHL, Embase and MEDLINE/PubMed databases were searched, observational and intervention studies published over the past 20 years. The quality of the studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).

Results

A total of 3770 infants diagnosed with gastroschisis were included (44 studies); 1534 fetuses were classified as simple gastroschisis and 288 as complex gastroschisis. Intrauterine fetal demise occurred in 0.47% and elective termination occurred in 0.13%. Preterm delivery occurred in 23.23% and intrauterine growth restriction in 4.43%. Cesarean section delivery was performed in 54.6%. Neonatal survival was 91.29%. The main neonatal complications were: sepsis (11.78%), necrotizing enterocolitis (2.33%), short bowel syndrome (1.37%), bowel obstruction (0.79%), and volvulus (0.23%). Immediate surgical repair was performed in 80.1% with primary closure in 69%. The average to oral feeding was 33 (range: 11–124.5) days. Average hospital duration was 38 days and 89 days in neonates with simple and complex grastroschisis, respectively.

Conclusions

The present systematic review provides scientific data for counseling families with fetal gastroschisis.

Keywords:

• Gastroschisis
• diagnostic imaging
• prenatal diagnosis
• ultrasonography
• prognosis
• postnatal care

Acknowledgments

Source(s) of financial support for the research: Own resources. This research received no external funding.

Disclosure statement

No potential conflict of interest was reported by the author(s). None of the authors have relevant direct financial relationship to the manuscript.

Additional information

Funding

Universidade Federal de Goiás for partial supporting.