COMPLICATIONS OF GASTROSCHISIS

ANTENATAL COMLICATIONS

Sonography cannot accurately predict impending bowel damage, and should not be used to make a decision to deliver a fetus prior to term (1).

• Bowel obstruction / perforation (2).
• Fetal IUGR (38-77%). Thought to be secondary to nutritional loss from the exposed bowel.
• Peritonitis due to exposed of bowel loops to fetal urine or meconium. This may be demonstrated antenatally as bowel dilatation or bowel wall thickening.
• Torsion of the midgut which may result in bowel necrosis (3).

COMPLICATIONS DURING DELIVERY

• Intestinal avulsion (during cesarean section) (4).

POSTNATAL COMPLICATIONS

• Malrotation / nonrotation of bowel loops.
• Prolonged intestinal mobility dysfunction.
• Bowel atresia / necrosis.
• Necrotizing enterocolitis.
• Hyperalimentation hepatitis.
• Chronic short gut syndrome.

REFERENCES

1. Babcock CJ, Hendrick MH, Goldstein RB et.al. Gastroschisis: Can sonography of fetal bowel accurately predict postnatal outcome. J Ultrasound Med 1994;13:701-706.
2. Emanuel PG, Garcia GI, Angtuaco TL. Prenatal detection of abdominal wall defects with US. Radiographics 1995;15:517-530.
3. Lenke RR, Persutte WH, Nemes J. Ultrasonographic assessment of intestinal damage in fetuses with gastroschisis: IS it of any clinical value. Am J Obstet Gynecol 1990;163:995.
4. Dinatti LA, Meagher DP, Martine-Frontanilla LA. "Bucket handle" avulsion of intestine in gastroschisis. J Pediatr Surg 1993;28:840.