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A Retrospective Review of Gastroschisis at The University Hospital of the West Indies: Factors affecting outcome

DOI: 
10.7727/wimj.2018.061
Pages: 

ABSTRACT

Objective: To identify the antenatal, perinatal and postnatal factors associated with adverse outcomes in infants diagnosed with gastroschisis at The University Hospital of the West Indies (UHWI) over a ten-year period.

Methods: A retrospective review of all cases of pregnancies complicated by gastroschisis over a ten-year period at the UHWI was conducted. The primary objective of this study is to determine the antenatal factors that affect adverse perinatal outcomes of neonates with gastroschisis. The composite adverse neonatal outcome comprised of death, preoperative and postoperative wound infection, sepsis, ventilator support, parenteral nutrition, bowel resection and the presence of hernia one-year post repair. Univariate and multivariate analysis were utilized to assess factors associated with adverse outcomes.

Results: There were 14 infants with gastroschisis at The University of the West Indies from 2006‒2016 included in the study. Among the cohort, six (42%) were born at the institution (inborn) while nine (64%) were transferred after birth (outborn) to UHWI for further management. Within the cohort 11 (79%) had one or more adverse outcome. Four infants died during their admission, giving a mortality rate of 29%. The period diagnosis (antenatal vs postnatal), birthweight, antenatal ultrasound surveillance and place of birth (Inborn vs outborn) were variables identified as predictors of adverse outcomes.

Conclusion: Antenatal diagnosis and birth in a tertiary centre, are factors that may be implemented to improve the outcomes of infants affected by gastroschisis.

 

Accepted: 
09 May, 2018
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e-Published: 26 Feb, 2019

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