A 25-year study of gastroschisis outcomes in a middle-income country
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In brief
In brief
Retrospective 25-year study of 156 gastroschisis cases in Brazil demonstrates improved survival after implementing protocolized prenatal diagnosis, delivery planning, and surgical management in 2002. Findings highlight the impact of standardized care protocols on neonatal surgical outcomes in resource-limited settings.
Written by the GCMD Library team from the article.
Background
Survival of newborns with gastroschisis is significantly higher in high-income versus low and middle-income countries. We reviewed treatment and outcomes of gastroschisis in a middle-income country setting with increasing protocolized management.
Methods
All newborns with gastroschisis treated during the period 1989–2013 at a single Brazilian academic surgical service were studied retrospectively. Protocolized diagnosis, delivery, nutrition, medical interventions, and surgical interventions were introduced in 2002. Outcomes before and after protocol introduction were studied using univariate and multivariate analysis.
Results
One hundred fifty-six newborns were treated for gastroschisis: 35 (22.4%) and 121 (77.6%) before and after 2002, respectively. When compared to the earlier cohort, patients treated after 2002 had higher rates of prenatal diagnosis (90.9% vs. 60.0%, p