Impact of the Mode of Delivery on Gastroschisis Anatomical Features in the Newborn Children

Introduction. The mode of delivery for gravidas with fetuses with GS plays an important role among the factors influencing the results of gastroschisis (GS) treatment. More researchers come to univocal conclusion that elective and early cesarean section has positive impact on elimination (prevention) of GS complications compared to previous experience in natural deliveries in term. However, the impact of the mode of delivery to anatomical features of GS remains still not investigated. The objective of the research was to determine the impact of the delivery mode on anatomical characteristics of newborn children with GS. Materials and methods. Retrospective analysis of 100 patients’ case histories was conducted. Infants were born naturally or via C-section during the period from 1987 to 2015. All newborns were divided into 3 clinical groups according to prenatal diagnosis, mode of delivery, transportation, place and term of surgical treatment of GS. Results. Localization of penetration defect of anterior abdominal wall (AAW) remains constant and typical for GS in every clinical group; therefore the mode of delivery did not have any impact upon the localization of defects in case of this malformation. The size of the penetration defect was significantly smaller in children after C-section than those born via vaginal deliveries. Thus, in Group I (children born via C-section) the defects sizes were 3.15?±?0.09 cm, while in Groups II and III (after vaginal deliveries) the sizes were 4.17?±?0.3 cm, p< 0.01, and 4.7?±?0.29 cm, p< 0.01, respectively. The eventration rate of retroperitoneal organs (pancreas and duodenum) was significantly higher in children with GS born via natural mode of delivery (II and III clinical group) than in neonates born via C-section (I clinical group), constituting 56.0% and 63.3% to 25.0%, respectively, with p< 0.01. Conclusions. The mode of delivery (C-section or vaginal) has impact on anatomical features of GS in the newborns. The size of AAW defect is significantly greater in children with GS born vaginally than in infants born via C-section and eventeration rate of retroperitoneal organs (pancreas and duodenum) is higher.