Abstract

PACHAJOA, Harry; URREA, María Fernanda  and  TORRES, Javier. Gastroschisis in the Neonatal Intensive Care Unit of the Hospital Universitario del Valle (Cali, Colombia): 2000-2004. Iatreia [online]. 2009, vol.22, n.3, pp.213-218. ISSN 0121-0793.

Introduction:Gastroschisis is a congenital malformation of the abdominal wall. It is convenient to study it in different pediatric centers because its prevalence rate has markedly increased in several countries. Objectives:To define the epidemiological and clinical characteristics of a group of newborn infants with gastroschisis. Methods: A descriptive-retrospective study was carried out between January 1, 2000, and December 31, 2004. It included 29 of the 35 newborn infants with gastroschisis treated at the Neonatal Intensive Care Unit, Hospital Universitario del Valle, in Cali, Colombia. Results: Average maternal age was 18.8 years. Twenty of the mothers (69.0%) were younger than 20 years, and 22 (75.9%) were primiparae. The study included 16 girls (55.2%) and 13 boys (44.8%). Fifteen infants (51.7%) were born by caesarean section and 14 (48.3%), by natural birth. Twelve (41.4%) were born at term and 17 (58.6%) were preterm babies. Nineteen (65.5%) had low birth weight. In 10 cases (34.5%) the diagnosis of gastroschisis was prenatally established. Average diameter of the defect (registered in 19 cases) was 4.28 cm. There were associated malformations in 16 patients (55.2%), 12 of which were of the gastrointestinal tract. Ten (66.6%) of the 15 infants born by caesarean section had associated malformations. Complications occurred in 28 infants (96.6%), mostly sepsis (23 cases). Ten infants (34.5%) died, 8 of them in septic shock. Conclusions: Maternal age under 20 years and primiparous women predominated in this study. The main morbidity cause was sepsis. Differences in the mortality rate were found according to the place of origin of the patients: it was higher in those referred from towns different from Cali. Distance and, consequently, the time required for reaching the ICU may have been associated with the probability of death; however, the small number of cases does not allow definitive conclusions in this respect. The death rate found in our study was similar to that reported from other Latin American hospitals for similar patients, but exceeded the one from institutions in developed countries.

Keywords : Congenital malformations; Gastroschisis; Neonatal intensive care; Neonatal morbidity; Neonatal mortality.

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