[size=20px]You are counseling parents with a fetus with gastroschisis. You recommend which type of delivery for a patient with gastroschisis?

 

A vaginal induced before 35 week gestation.

 

B vaginal at spontaneous labor.

 

C Cesarean before 35 week gestation.

 

D scheduled Cesarean at term.

 

E Cesarean after 40 week gestation.[/size]

(Untitled)

 

A

(Untitled)

 

b

b

correct

 

There is some controversy in the literature regarding preterm versus term delivery of infants with gastroschisis. Some centers will routinely use preterm delivery and cesarean section with good results in terms of length of stay in single center reports. Larger studies have demonstrated that delivery before 35 weeks results in more respiratory complications and does not reduce the overall inflammatory peel on the intestines. The obstetric literature also suggests that vaginal delivery is preferred for fetuses with an abdominal wall defect - gastroshisis or omphalocele. Cesarean delivery rates are much higher in the United States in children with abdominal wall defects compared to other countries. Overall, the evidence is in favor of spontaneous vaginal deliveries.