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Pediatric Surgery International

Erschienen in:

01.09.2010 | Review Article

Gastroschisis: an update

verfasst von: Andrew J. A. Holland, Karen Walker, Nadia Badawi

Erschienen in: Pediatric Surgery International | Ausgabe 9/2010

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Abstract

Gastroschisis (GS) continues to increase in frequency, with several studies now reported an incidence of between 4 and 5 per 10,000 live births. The main risk factor would seem to be young maternal age, and it is in this group that the greatest increase has occurred. Whilst various geographical regions confer a higher risk, the impact of several other putative risk factors, including smoking and illicit drug use, may be less important than when first identified in early epidemiological studies. Over 90% of cases of GS will now be diagnosed on antenatal ultrasound, but its value in determining the need for early delivery remains unclear. There would appear no clear evidence for either routine early delivery or elective caesarean section for infants with antenatally diagnosed GS. Delivery at a centre with paediatric surgical facilities reduces the risk of subsequent morbidity and should represent the standard of care. The relative roles of primary closure, staged closure and ward reduction, with or without general anaesthesia, appear less clear with considerable variation between centres in both the use of these techniques and subsequent surgical outcomes. Survival rates continue to improve, with rates well in excess of 90% now routine. The limited long-term developmental data available would suggest that normal or near-normal outcomes may be expected although there remains a need for further studies.

Wilson RD, Johnson MP (2004) Congenital abdominal wall defects: an update. Fetal Diagn Ther 19:385–398PubMedCrossRef

Bernstein P (1940) Gastroschisis, a rare teratological condition in the newborn. Arch Pediatr 57:505–513

David AL, Tan A, Curry J (2008) Gastroschisis: sonographic diagnosis, associations, management and outcome. Prenat Diagn 28:633–644PubMedCrossRef

Islam S (2008) Clinical care outcomes in abdominal wall defects. Curr Opin Pediatr 20:305–310PubMedCrossRef

Jacob C, Langer M (2003) Abdominal wall defects. World J Surg 27:117–124CrossRef

Maksoud-Filho JG, Tannuri U, da Silva MM et al (2006) The outcome of newborns with abdominal wall defects according to the method of abdominal closure: the experience of a single center. Pediatr Surg Int 22:503–507PubMedCrossRef

Lee TC, Barshes NR, Nguyen L et al (2005) Gastroschisis and biliary atresia in a neonate: uncommon presentation or common precipitant. Eur J Pediatr Surg 15:434–436PubMedCrossRef

Gow KW, Bhatia A, Saad DF et al (2006) Left-sided gastroschisis. Am Surg 72:637–640PubMed

Suver D, Lee SL, Shekherdimian S et al (2008) Left-sided gastroschisis: higher incidence of extraintestinal congenital anomalies. Am J Surg 195:663–666PubMedCrossRef

10.

Chen CP (2007) Ruptured omphalocele with extracorporeal intestines mimicking gastroschisis in a fetus with Turner syndrome. Prenat Diagn 27:1067–1068PubMedCrossRef

11.

Weber TR, Au-Fliegner M, Downard CD et al (2002) Abdominal wall defects. Curr Opin Pediatr 14:491–497PubMedCrossRef

12.

Kiesewtter WB (1957) Gastroschisis: report of a case. AMA Arch Surg 75:28–30

13.

Bianchi A, Dickson AP (1998) Elective delayed reduction and no anesthesia: ‘minimal intervention management’ for gastroschisis. J Pediatr Surg 33:1338–1340PubMedCrossRef

14.

Schlatter M, Norris K, Uitvlugt N et al (2003) Improved outcomes in the treatment of gastroschisis using a preformed silo and delayed repair approach. J Pediatr Surg 38:459–464PubMedCrossRef

15.

Goulet O, Sauvat F (2006) Short bowel syndrome and intestinal transplantation in children. Curr Opin Clin Nutr Metab Care 9:304–313PubMedCrossRef

16.

Zaccara B, Iacobelli A, Calzolari A et al (2003) Cardiopulmonary performances in young children and adolescents born with large abdominal wall defects. J Paediatr Surg 38:478–481CrossRef

17.

Moore TC (1963) Gastroschisis with antenatal evisceration of intestines and urinary bladder. Ann Surg 158:263–269PubMedCrossRef

18.

Mann L, Ferguson-Smith MA, Desai M et al (1984) Prenatal assessment of anterior abdominal wall defects and their prognosis. Prenat Diagn 4:427–435PubMedCrossRef

19.

Lafferty PM, Emmerson AJ, Fleming PJ et al (1989) Anterior abdominal wall defects. Arch Dis Child 64:1029–1031PubMedCrossRef

20.

Moore TC (1977) Gastroschisis and omphalocele: clinical differences. Surgery 82:561–568PubMed

21.

Tan KH, Kilby MD, Whittle MJ et al (1996) Congenital anterior abdominal wall defects in England and Wales 1987–93: retrospective analysis of OPCS data. Br Med J 313:903–906

22.

Rankin J, Dillon E, Wright C (1999) Congenital anterior abdominal wall defects in the north of England, 1986–1996: occurrence and outcome. Prenat Diagn 19:662–668PubMedCrossRef

23.

Rankin J, Pattenden S, Abramsky L et al (2005) Prevalence of congenital anomalies in five British regions, 1991–99. Arch Dis Child Fetal Neonatal Ed 90:F374–F379PubMedCrossRef

24.

Loane M, Dolk H, Bradbury I (2007) Increasing prevalence of gastroschisis in Europe 1980–2002: a phenomenon restricted to younger mothers? Paediatr Perinat Epidemiol 21:363–369PubMedCrossRef

25.

Laughon M, Meyer R, Bose C et al (2003) Rising birth prevalence of gastroschisis. J Perinatol 23:291–293PubMedCrossRef

26.

Feldkamp ML, Carey JC, Sadler TW (2007) Development of gastroschisis: review of hypotheses, a novel hypothesis, and implications for research. Am J Med Genet 143A:639–652CrossRef

27.

Forrester MB, Merz RD (2006) Comparison of trends in gastroschisis and prenatal illicit drug use rates. J Toxicol Environ Health 69:1253–1259CrossRef

28.

Mac BT, Robbins JM, Druschel C et al (2009) Demographic and environmental risk factors for gastroschisis and omphalocele in the National Birth Defects Prevention Study. J Pediatr Surg 44:1546–1551CrossRef

29.

Hougland KT, Hanna AM, Meyers R et al (2005) Increasing prevalence of gastroschisis in Utah. J Pediatr Surg 40:535–540PubMedCrossRef

30.

Lam PK, Torfs CP (2006) Interaction between maternal smoking and malnutrition in infant risk of gastroschisis. Birth Defects Res Clin Mol Teratol 76:182–186CrossRef

31.

Siega-Riz AM, Olshan AF, Werler MM et al (2006) Fat intake and the risk of gastroschisis. Birth Defects Res Clin Mol Teratol 76:241–245CrossRef

32.

Torfs CP, Christianson RE, Iovannisci DM et al (2006) Selected gene polymorphisms and their interaction with maternal smoking, as risk factors for gastroschisis. Birth Defects Res Clin Mol Teratol 76:723–730CrossRef

33.

Werler MM (2006) Teratogen update: pseudoephedrine. Birth Defects Res Clin Mol Teratol 76:445–452CrossRef

34.

Werler MM, Mitchell AA, Moore CA et al (2009) Is there epidemiologic evidence to support vascular disruption as a pathogenesis of gastroschisis? Am J Med Genet 149A:1399–1406PubMedCrossRef

35.

Werler MM, Sheehan JE, Mitchell AA (2002) Maternal medication use and risks of gastroschisis and small intestinal atresia. Am J Epidemiol 155:26–31PubMedCrossRef

36.

Fielder HM, Poon-King CM, Palmer SR et al (2000) Assessment of impact on health of residents living near the Nant-y-Gwyddon landfill site: retrospective analysis. Br Med J 320:19–22CrossRef

37.

Hwang P-J, Kousseff BG (2004) Omphalocele and gastroschisis: an 18 year review study. Genet Med 6:232–236PubMedCrossRef

38.

Vermeij-Keers C, Hartwig NG, van der Werff JF (1996) Embryonic development of the ventral body wall and its congenital malformations. Semin Pediatr Surg 5:82–89PubMed

39.

Murphy FL, Mazlan TA, Tarheen F et al (2007) Gastroschisis and exomphalos in Ireland 1998–2004. Does antenatal diagnosis impact on outcome? Pediatr Surg Int 23:1059–1063PubMedCrossRef

40.

Vegunta RK, Wallace LJ, Leonardi MR et al (2005) Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg 40:528–534PubMedCrossRef

41.

Drewett M, Michailidis GD, Burge D (2006) The perinatal management of gastroschisis. Early Hum Dev 82:305–312PubMedCrossRef

42.

Richmond S, Atkins J (2005) A population-based study of the prenatal diagnosis of congenital malformation over 16 years. Br J Obstet Gynaecol 112:1349–1357

43.

Algert CS, Bowen JR, Hadfield RM et al (2008) Birth at hospitals with co-located paediatric units for infants with correctable birth defects. Aust N Z J Obstet Gynaecol 48:273–279PubMedCrossRef

44.

Fillingham A, Rankin J (2008) Prevalence, prenatal diagnosis and survival of gastroschisis. Prenat Diagn 28:1232–1237PubMedCrossRef

45.

Davis RP, Treadwell MC, Drongowski RA et al (2009) Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome? Pediatr Surg Int 25:319–325PubMedCrossRef

46.

Palomaki GE, Hill LE, Knight GJ et al (1988) Second-trimester maternal serum alpha-fetoprotein levels in pregnancies associated with gastroschisis and omphalocele. Obstet Gynecol 71:906–909PubMed

47.

Nicholas SS, Stamilio DM, Dicke JM et al (2009) Predicting adverse neonatal outcomes in fetuses with abdominal wall defects using prenatal risk factors. Am J Obstet Gynecol 201:383–386PubMedCrossRef

48.

Cedergren M, Selbing A (2006) Detection of fetal structural abnormalities by an 11–14-week ultrasound dating scan in an unselected Swedish population. Acta Obstet Gynecol Scand 85:912–915PubMedCrossRef

49.

Luton D, Guibourdenche J, Vuillard E et al (2003) Prenatal management of gastroschisis: the place of the amnioexchange procedure. Clin Perinatol 30:551–572PubMedCrossRef

50.

Reid KP, Dickinson JE, Doherty DA (2003) The epidemiologic incidence of congenital gastroschisis in Western Australia. Am J Obstet Gynecol 189:764–768PubMedCrossRef

51.

Srivastava V, Mandhan P, Pringle K et al (2009) Rising incidence of gastroschisis and exomphalos in New Zealand. J Pediatr Surg 44:551–555PubMedCrossRef

52.

Kandasamy Y, Whitehall J, Gill A et al (2010) Surgical management of gastroschisis in North Queensland from 1988 to 2007. J Paediatr Child Health 46(1–2):40–44

53.

Puligandla PS, Janvier A, Flageole H et al (2004) The significance of intrauterine growth restriction is different from prematurity for the outcome of infants with gastroschisis. J Pediatr Surg 39:1200–1204PubMedCrossRef

54.

Towers CV, Carr MH (2008) Antenatal fetal surveillance in pregnancies complicated by fetal gastroschisis. Am J Obstet Gynecol 198:686–695PubMed

55.

Payne NR, Pfleghaar K, Assel B et al (2009) Predicting the outcome of newborns with gastroschisis. J Pediatr Surg 44:918–923PubMedCrossRef

56.

Fleet MS, de La Hunt MN (2000) Intestinal atresia with gastroschisis: a selective approach to management. J Pediatr Surg 35:1323–1325PubMedCrossRef

57.

Lawson A, de La Hunt MN (2001) Gastroschisis and undescended testis. J Pediatr Surg 36:366–367PubMedCrossRef

58.

Lao OB, Larison C, Garrison MM et al (2010) Outcomes in neonates with gastroschisis in U.S. children’s hospitals. Am J Perinatol 27:97–101PubMedCrossRef

59.

Franchi-Teixeira AR, Weber Guimaraes BM, Nogueira B et al (2005) Amniotic fluid and intrauterine growth restriction in a gastroschisis fetal rat model. Fetal Diagn Ther 20:494–497PubMedCrossRef

60.

Japaraj RP, Hockey R, Chan FY (2003) Gastroschisis: can prenatal sonography predict neonatal outcome? Ultrasound Obstet Gynecol 21:329–333PubMedCrossRef

61.

Marder AL, Moise K Jr, Chuang A et al (2008) Amnioexchange for the treatment of gastroschisis—an in vitro study to determine the volume and number of exchanges needed. Fetal Diagn Ther 23:95–99PubMedCrossRef

62.

Kohl T, Tchatcheva K, Stressig R et al (2009) Is there a therapeutic role for fetoscopic surgery in the prenatal treatment of gastroschisis? A feasibility study in sheep. Surg Endosc 23:1499–1505PubMedCrossRef

63.

Fasching G, Haeusler M, Mayr J et al (2005) Can levels of interleukins and matrix metalloproteinases in the amniotic fluid predict postnatal bowel function in fetuses with gastroschisis? J Pediatr Surg 40:1887–1891PubMedCrossRef

64.

Cohen-Overbeek TE, Hatzmann TR, Steegers EA et al (2008) The outcome of gastroschisis after a prenatal diagnosis or a diagnosis only at birth. Recommendations for prenatal surveillance. Eur J Obstet Gynecol Reprod Biol 139:21–27PubMedCrossRef

65.

Ledbetter DJ (2006) Gastroschisis and omphalocele. Surg Clin North Am 86:249–260PubMedCrossRef

66.

Chabra S (2006) Management of gastroschisis: prenatal, perinatal and neonatal. Neoreviews 7:e419–e427CrossRef

67.

Salomon LJ, Mahieu-Caputo D, Jouvet P et al (2004) Fetal home monitoring for the prenatal management of gastroschisis. Acta Obstet Gynecol Scand 83:1061–1064PubMed

68.

Abdel-Latif ME, Bolisetty S, Abeywardana S et al (2008) Mode of delivery and neonatal survival of infants with gastroschisis in Australia and New Zealand. J Pediatr Surg 43:1685–1690PubMedCrossRef

69.

Lausman AY, Langer JC, Tai M et al (2007) Gastroschisis: what is the average gestational age of spontaneous delivery? J Pediatr Surg 42:1816–1821PubMedCrossRef

70.

Bond SJ, Harrison MR, Filly RA et al (1988) Severity of intestinal damage in gastroschisis: correlation with prenatal sonographic findings. J Pediatr Surg 23:520–525PubMedCrossRef

71.

Moir CR, Ramsey PS, Ogburn PL et al (2004) A prospective trial of elective preterm delivery for fetal gastroschisis. Am J Perinatol 21:289–294PubMedCrossRef

72.

Logghe HL, Mason GC, Thornton JG et al (2005) A randomized controlled trial of elective preterm delivery of fetuses with gastroschisis. J Pediatr Surg 40:1726–1731PubMedCrossRef

73.

Huang J, Kurkchubasche AG, Carr SR et al (2002) Benefits of term delivery in infants with antenatally diagnosed gastroschisis. Obstet Gynecol 100:695–699PubMedCrossRef

74.

Maramreddy H, Fisher J, Slim M et al (2009) Delivery of gastroschisis patients before 37 weeks of gestation is associated with increased morbidities. J Pediatr Surg 44:1360–1366PubMedCrossRef

75.

Mozurkewich E, Chilimigras J, Koepke E et al (2009) Indications for induction of labour: a best-evidence review. Br J Obstet Gynaecol 116:626–636

76.

Houben C, Davenport M, Ade-Ajayi N et al (2009) Closing gastroschisis: diagnosis, management, and outcomes. J Pediatr Surg 44:343–347PubMedCrossRef

77.

Nick AM, Bruner JP, Moses R et al (2006) Second-trimester intra-abdominal bowel dilation in fetuses with gastroschisis predicts neonatal bowel atresia. Ultrasound Obstet Gynecol 28:821–825PubMedCrossRef

78.

Skarsgard ED, Claydon J, Bouchard S et al (2008) Canadian Pediatric Surgical Network: a population-based pediatric surgery network and database for analyzing surgical birth defects. The first 100 cases of gastroschisis. J Pediatr Surg 43:30–34PubMedCrossRef

79.

Piper HG, Jaksic T (2006) The impact of prenatal bowel dilation on clinical outcomes in neonates with gastroschisis. J Pediatr Surg 41:897–900PubMedCrossRef

80.

Clark RH, Walker MW, Gauderer MW (2009) Prevalence of gastroschisis and associated hospital time continue to rise in neonates who are admitted for intensive care. J Pediatr Surg 44:1108–1112PubMedCrossRef

81.

Segel SY, Marder SJ, Parry S et al (2001) Fetal abdominal wall defects and mode of delivery: a systematic review. Obstet Gynecol 98:867–873PubMedCrossRef

82.

Marven S, Owen A (2008) Contemporary postnatal surgical management strategies for congenital abdominal wall defects. Semin Pediatr Surg 17:222–235PubMedCrossRef

83.

Kitchanan S, Patole SK, Muller R et al (2000) Neonatal outcome of gastroschisis and exomphalos: a 10-year review. J Paediatr Child Health 36:428–430PubMedCrossRef

84.

Singh SJ, Fraser A, Leditschke JF et al (2003) Gastroschisis: determinants of neonatal outcome. Pediatr Surg Int 19:260–265PubMedCrossRef

85.

Robilio D, Greve L, Towner D (2001) Gastroschisis outcomes and the site of delivery. Am J Obstet Gynecol 185:S244CrossRef

86.

Chiu B, Lopoo J, Hoover JD et al (2006) Closing arguments for gastroschisis: management with silo reduction. J Perinat Med 34:243–245PubMedCrossRef

87.

Jensen AR, Waldhausen JH, Kim SS (2009) The use of a spring-loaded silo for gastroschisis: impact on practice patterns and outcomes. Arch Surg 144:516–519PubMedCrossRef

88.

Allotey J, Davenport M, Njere I et al (2007) Benefit of preformed silos in the management of gastroschisis. Pediatr Surg Int 23:1065–1069PubMedCrossRef

89.

Fischer JD, Chun K, Moores DC et al (1995) Gastroschisis: a simple technique for staged silo closure. J Pediatr Surg 30:1169–1171PubMedCrossRef

90.

Owen A, Marven S, Jackson L et al (2006) Experience of bedside preformed silo staged reduction and closure for gastroschisis. J Pediatr Surg 41:1830–1835PubMedCrossRef

91.

Hong L, Wu YM, Yan ZL et al (2010) Modified silo technique—an easy and effective method to improve the survival rate of neonates with gastroschisis in Shanghai. Eur J Obstet Gynecol Reprod Biol 148:31–34PubMedCrossRef

92.

Banieghbal B, Gouws M, Davies MR (2006) Respiratory pressure monitoring as an indirect method of intra-abdominal pressure measurement in gastroschisis closure. Eur J Pediatr Surg 16:79–83PubMedCrossRef

93.

Davies MW, Kimble RM, Cartwright DW (2005) Gastroschisis: ward reduction compared with traditional reduction under general anesthesia. J Pediatr Surg 40:523–527PubMedCrossRef

94.

Kimble RM, Singh SJ, Bourke C et al (2001) Gastroschisis reduction under analgesia in the neonatal unit. J Pediatr Surg 36:1672–1674PubMedCrossRef

95.

Bianchi A, Dickson AP, Alizai NK (2002) Elective delayed midgut reduction—no anesthesia for gastroschisis: selection and conversion criteria. J Pediatr Surg 37:1334–1336PubMedCrossRef

96.

Dolgin SE, Midulla P, Shlasko E (2000) Unsatisfactory experience with ‘minimal intervention management’ for gastroschisis. J Pediatr Surg 35:1437–1439PubMedCrossRef

97.

Rao SC, Pirie S, Minutillo C et al (2010) Ward reduction of gastroschisis in a single stage without general anaesthesia may increase the risk of short-term morbidities: results of a retrospective audit. J Paediatr Child Health (in press)

98.

Davies MW, Kimble RM, Woodgate PG (2002) Ward reduction without general anaesthesia versus reduction and repair under general anaesthesia for gastroschisis in newborn infants. Cochrane Database Syst Rev (3):CD003671

99.

Salihu HM, Emusu D, Aliyu ZY et al (2004) Mode of delivery and neonatal survival of infants with isolated gastroschisis. Obstet Gynecol 104:678–683PubMed

100.

Sharp M, Bulsara M, Gollow I et al (2000) Gastroschisis: early enteral feeds may improve outcome. J Paediatr Child Health 36:472–476PubMedCrossRef

101.

Charlesworth P, Njere I, Allotey J et al (2007) Postnatal outcome in gastroschisis: effect of birth weight and gestational age. J Pediatr Surg 42:815–818PubMedCrossRef

102.

van Eijck FC, Wijnen RM, van Goor H (2008) The incidence and morbidity of adhesions after treatment of neonates with gastroschisis and omphalocele: a 30-year review. J Pediatr Surg 43:479–483PubMedCrossRef

103.

Teoh L, Wong CK, Martin H et al (2005) Anterior abdominal wall defects and biliary obstruction. J Paediatr Child Health 41:143–146PubMedCrossRef

104.

Nathan JD, Rudolph JA, Kocoshis SA et al (2007) Isolated liver and multivisceral transplantation for total parenteral nutrition-related end-stage liver disease. J Pediatr Surg 42:143–147PubMedCrossRef

105.

Curry JI, Lander AD, Stringer MD (2004) A multicenter, randomized, double-blind, placebo-controlled trial of the prokinetic agent erythromycin in the postoperative recovery of infants with gastroschisis. J Pediatr Surg 39:565–569PubMedCrossRef

106.

Ng E, Shah VS (2008) Erythromycin for the prevention and treatment of feeding intolerance in preterm infants. Cochrane Database Syst Rev (3):CD001815

107.

Lunzer H, Menardi G, Brezinka C (2001) Long-term follow-up of children with prenatally diagnosed omphalocele and gastroschisis. J Matern Fetal Med 10:385–392PubMed

108.

Berseth CL, Malachowski N, Cohn RB et al (1982) Longitudinal growth and late morbidity of survivors of gastroschisis and omphalocele. J Pediatr Gastroenterol Nutr 1:375–379PubMedCrossRef

109.

South AP, Marshall DD, Bose CL et al (2008) Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis. J Perinatol 28:702–706PubMedCrossRef

110.

Henrich K, Huemmer HP, Reingruber B et al (2008) Gastroschisis and omphalocele: treatments and long-term outcomes. Pediatr Surg Int 24:167–173PubMedCrossRef

111.

Walker K, Holland AJ, Winlaw D et al (2006) Neurodevelopmental outcomes and surgery in neonates. J Paediatr Child Health 42:749–751PubMedCrossRef

112.

Minutillo C, Pirie S, McMichael J, Dickinson JE, Rao SC (2009) Neurodevelopmental outcomes of infants with gastroschisis in Western Australia: a retrospective study. J Paediatr Child Health 45:A60

Titel: Gastroschisis: an update
verfasst von: Andrew J. A. Holland
Karen Walker
Nadia Badawi
Publikationsdatum: 01.09.2010
Verlag: Springer-Verlag
Erschienen in: Pediatric Surgery International / Ausgabe 9/2010
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-010-2679-1

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