Gastroschisis: five cases after primary closure at Sanglah General Hospital, Bali, Indonesia

Nyoman Gina Henny Kristianti; I Wayan Darma Artana; I Made Kardana; Putu Junara Putra; Made Sukmawati; Kadek Deddy Ariyanta; Made Darmajaya

doi:10.15562/ism.v11i3.730

Gastroschisis: five cases after primary closure at Sanglah General Hospital, Bali, Indonesia

Nyoman Gina Henny Kristianti ,

I Wayan Darma Artana ,

I Made Kardana ,

Putu Junara Putra ,

Made Sukmawati ,

Kadek Deddy Ariyanta ,

Made Darmajaya ,

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DOI: https://doi.org/10.15562/ism.v11i3.730 |
Published: 2020-12-01

Abstract

Background: Gastroschisis is a congenital anterior abdominal wall defect characterized by intra-abdominal organs evisceration without covering the membrane. Several risk factors affect the outcome of a gastroschisis patient. Considering these risk factors might also increase the chance of better prognosis and survival. We report five neonates with gastroschisis after primary closure in Sanglah General Hospital, Denpasar, Bali, in 2017. This case series aims to describe the clinical characteristics and outcome of different babies with gastroschisis managed by primary closure surgery.

Case Presentation: Four of our cases were detected during pregnancy with fetal gastroschisis at the age of 32, 19, 23, 25 weeks of gestation, respectively. We reserve cesarean delivery for the patient who did antenatal care in our hospital, but one of our patients was born by spontaneous labor due to lack of antenatal care. Four cases had the primary closure of less than 2 hours and one of them after 10 hours. Good outcome was found in three cases that started enteral feeding on the 7^th day after post closure. Other cases started oral feeding on the 3^rd day and 12^th day—both of them shown poor outcomes. Three cases survive, but two others died because of sepsis.

Conclusion: We found poor outcomes in both cases, which neonatal sepsis as a significant cause. One of our cases with poor outcome was referred from another hospital without antenatal care and had a long duration of entering the operating room. Diagnosing these babies in their early prenatal period and transferring them to an experienced medical centre containing multidisciplinary working facilities will contribute to both the mother and the baby's health.

References

Lepigeon K, Van Mieghem T, Vasseur Maurer S, Giannoni E, Baud D. Gastroschisis--what should be told to parents?. Prenat Diagn. 2014;34(4):316-326.
Morazán AF, Andrade DS, Torres SJ, Zelaya WP, Izaguirre RE, Molina FA, Gonzalez CH. Non-viable Neonatal Gastroschisis: Case Report. Journal of Clinical Epigenetics. 2017:3(2);2472-8.
Cortes-Matus NF, Barrera-Salcedo JI, Villareal-Careaga J. Factors associated with gastroschisis in newborns at Culiacan General Hospital. General de Culiacan Ach Salud. 2010;4:14-7.
Sparks TN, Shaffer BL, Page J, Caughey AB. Gastroschisis: mortality risks with each additional week of expectant management. Am J Obstet Gynecol. 2017;216(1):66.e1-66.e7.
Vegunta RK, Wallace LJ, Leonardi MR, Gross TL, Renfroe Y, Marshall JS, et al. Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg. 2005;40(3):528-534.
Rittler M, Campaña H, Ermini ML, Gili JA, Poletta FA, Pawluk MS, et al. Gastroschisis and young mothers: What makes them different from other mothers of the same age?. Birth Defects Res A Clin Mol Teratol. 2015;103(6):536-543.
Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update. 2011;17(5):589-604.
O'Connell RV, Dotters-Katz SK, Kuller JA, Strauss RA. Gastroschisis: A Review of Management and Outcomes. Obstet Gynecol Surv. 2016;71(9):537-544.
Kirollos DW, Abdel-Latif ME. Mode of delivery and outcomes of infants with gastroschisis: a meta-analysis of observational studies. Arch Dis Child Fetal Neonatal Ed. 2018;103(4):F355-F363.
Schib K, Schumacher M, Meuli M, Tharakan S, Subotic U. Prenatal and Postnatal Management of Gastroschisis in German-Speaking Countries: Is There a Standardized Management?. Eur J Pediatr Surg. 2018;28(2):183-193.
Baud D, Lausman A, Alfaraj MA, et al. Expectant management compared with elective delivery at 37 weeks for gastroschisis. Obstet Gynecol. 2013;121(5):990-998.
Safavi A, Skarsgard ED. Advances in the Surgical Treatment of Gastroschisis. Surg Technol Int. 2015;26:37-41.
Schmidt AF, Gonçalves A, Bustorff-Silva JM, Oliveira Filho AG, Marba ST, Sbragia L. Does staged closure have a worse prognosis in gastroschisis?. Clinics (Sao Paulo). 2011;66(4):563-566.
Thompson JP, Walker K, Haliday R, Holland AJA, Trivedi A. Early enteral feeding following repair of gastroschisis is associated with shorter length of admission and better nutritional outcomes. J Clin Neonatol. 2017;6:231-235.
Singh SJ, Fraser A, Leditschke JF, Spence K, Kimble R, Payne JD, et al. Gastroschisis: determinants of neonatal outcome. Pediatr Surg Int. 2003;19(4):260-265.
Erdo?an D, Az?l? MN, Cavu?o?lu YH, Tuncer IS, Karaman I, Karaman A, et al. 11-year experience with gastroschisis: factors affecting mortality and morbidity. Iran J Pediatr. 2012;22(3):339-343.
Marshall Niles SG, Mitchell-Fearon K, Gill MI, DeSouza CJ, Fearon IC, Abel CA, et al. Mortality-related factors in gastroschisis - a Jamaican perspective. J Pediatr Surg. 2017;52(4):530-533.
Ziegler MJ, Pellegrini DC, Safdar N. Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Infection. 2015;43(1):29-36.
Rogers WK, Garcia L. Intraabdominal Hypertension, Abdominal Compartment Syndrome, and the Open Abdomen. Chest. 2018;153(1):238-250.

[1] Lepigeon K, Van Mieghem T, Vasseur Maurer S, Giannoni E, Baud D. Gastroschisis--what should be told to parents?. Prenat Diagn. 2014;34(4):316-326.

[2] Morazán AF, Andrade DS, Torres SJ, Zelaya WP, Izaguirre RE, Molina FA, Gonzalez CH. Non-viable Neonatal Gastroschisis: Case Report. Journal of Clinical Epigenetics. 2017:3(2);2472-8.

[3] Cortes-Matus NF, Barrera-Salcedo JI, Villareal-Careaga J. Factors associated with gastroschisis in newborns at Culiacan General Hospital. General de Culiacan Ach Salud. 2010;4:14-7.

[4] Sparks TN, Shaffer BL, Page J, Caughey AB. Gastroschisis: mortality risks with each additional week of expectant management. Am J Obstet Gynecol. 2017;216(1):66.e1-66.e7.

[5] Vegunta RK, Wallace LJ, Leonardi MR, Gross TL, Renfroe Y, Marshall JS, et al. Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg. 2005;40(3):528-534.

[6] Rittler M, Campaña H, Ermini ML, Gili JA, Poletta FA, Pawluk MS, et al. Gastroschisis and young mothers: What makes them different from other mothers of the same age?. Birth Defects Res A Clin Mol Teratol. 2015;103(6):536-543.

[7] Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update. 2011;17(5):589-604.

[8] O'Connell RV, Dotters-Katz SK, Kuller JA, Strauss RA. Gastroschisis: A Review of Management and Outcomes. Obstet Gynecol Surv. 2016;71(9):537-544.

[9] Kirollos DW, Abdel-Latif ME. Mode of delivery and outcomes of infants with gastroschisis: a meta-analysis of observational studies. Arch Dis Child Fetal Neonatal Ed. 2018;103(4):F355-F363.

[10] Schib K, Schumacher M, Meuli M, Tharakan S, Subotic U. Prenatal and Postnatal Management of Gastroschisis in German-Speaking Countries: Is There a Standardized Management?. Eur J Pediatr Surg. 2018;28(2):183-193.

[11] Baud D, Lausman A, Alfaraj MA, et al. Expectant management compared with elective delivery at 37 weeks for gastroschisis. Obstet Gynecol. 2013;121(5):990-998.

[12] Safavi A, Skarsgard ED. Advances in the Surgical Treatment of Gastroschisis. Surg Technol Int. 2015;26:37-41.

[13] Schmidt AF, Gonçalves A, Bustorff-Silva JM, Oliveira Filho AG, Marba ST, Sbragia L. Does staged closure have a worse prognosis in gastroschisis?. Clinics (Sao Paulo). 2011;66(4):563-566.

[14] Thompson JP, Walker K, Haliday R, Holland AJA, Trivedi A. Early enteral feeding following repair of gastroschisis is associated with shorter length of admission and better nutritional outcomes. J Clin Neonatol. 2017;6:231-235.

[15] Singh SJ, Fraser A, Leditschke JF, Spence K, Kimble R, Payne JD, et al. Gastroschisis: determinants of neonatal outcome. Pediatr Surg Int. 2003;19(4):260-265.

[16] Erdo?an D, Az?l? MN, Cavu?o?lu YH, Tuncer IS, Karaman I, Karaman A, et al. 11-year experience with gastroschisis: factors affecting mortality and morbidity. Iran J Pediatr. 2012;22(3):339-343.

[17] Marshall Niles SG, Mitchell-Fearon K, Gill MI, DeSouza CJ, Fearon IC, Abel CA, et al. Mortality-related factors in gastroschisis - a Jamaican perspective. J Pediatr Surg. 2017;52(4):530-533.

[18] Ziegler MJ, Pellegrini DC, Safdar N. Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Infection. 2015;43(1):29-36.

[19] Rogers WK, Garcia L. Intraabdominal Hypertension, Abdominal Compartment Syndrome, and the Open Abdomen. Chest. 2018;153(1):238-250.

Gastroschisis: five cases after primary closure at Sanglah General Hospital, Bali, Indonesia

Abstract

References

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