What is the current birth prevalence of gastroschisis in the UK?
How are gastroschisis-affected pregnancies managed?
What are the prognostic features associated with gastroschisis?
What are the outcomes for infants with gastroschisis?
Gastroschisis is a congenital anomaly of the anterior abdominal wall, in which gut and other abdominal contents are herniated through a defect in the wall to one side of the umbilicus. The condition has been noted to be increasing worldwide, although the reasons for this rise remain obscure. A number of reports, predominantly from regional congenital anomaly registers, have provided evidence that this increase is also occurring in the UK, leading to a call for further research on the condition by the Chief Medical Officer for England. This increase in birth prevalence of gastroschisis has been noted to occur particularly in infants of younger mothers. Additionally a North-South gradient in birth prevalence has been noted in the UK, although incomplete geographical coverage by regional congenital anomaly registers makes this difficult to study. Currently regional congenital anomaly registers cover only 50% of the UK population and ascertainment through the National Congenital Anomaly System (NCAS) is known to be poor. This UK-wide study will measure the incidence of gastroschisis and variations in incidence nationally.
The study will also investigate the current antenatal management of this condition in the UK. A number of issues continue to be debated in the literature, including antenatal monitoring and mode of delivery. Outcomes associated with different monitoring and delivery strategies will be described and compared.
All pregnant women with a fetus affected by gastroschisis.
Excluded: Aplasia or hypoplasia of abdominal muscles, skin-covered umbilical hernia or omphalocele.
The study will run initially for one year. The study will aim to collect data on 230 cases (based on an estimated incidence of 1 in 3000 births).
The study has been approved by the London MREC (study ref 05/MRE02/82).
The study has been approved by the London MREC (study ref 05/MRE02/83).