Outcome of gastroschisis in Rajshahi Medical College Hospital: Searching for the way of improvement

Abstract

Background: Gastroschisis is a congenital abdominal wall defect requiring complex surgical intervention. Its management remains challenging, especially in resource-limited settings. Objective: The primary objective was to evaluate the outcomes and associated factors in treating gastroschisis patients at Rajshahi Medical College Hospital from January 2020 to December 2021. Methods: We conducted a retrospective analysis of 50 gastroschisis cases. Patient data were collected, including demographics, mode of delivery, place of birth, term/preterm status, antenatal history, treatment modalities, surgical procedures, post-operative events, outcomes, associated illnesses, post-operative complications, and duration of stay. Percentages were calculated for various variables to provide insights into the patient population and outcomes. Results: The study 50 patients examining gastroschisis outcomes and management. Gender distribution revealed 29 males (58.3%) and 21 females (41.7%). Regarding mode of delivery, 32 patients (63.9%) underwent Normal Vaginal Delivery (NVD), while 18 (36.1%) had Caesarian Section. Most patients (90.3%) were born out of hospitals. Gestational age distribution showed 70.8% term and 29.2% preterm births. Among the patients, 61.1% had a birth weight over 2.5 kg. Operative treatment was administered to 45 patients (90%), while 5 (10%) died before surgery. Primary repair was the most common treatment (57.7%), followed by Silo closure with staged repair (33.41%). These findings suggest a need for tailored interventions based on patient characteristics. Conclusions: This study highlights the challenges in managing gastroschisis at our institution, particularly in cases with high cardiac arrest and mortality rates. Improving pre-operative care, surgical techniques, and post-operative monitoring are needed to enhance patient outcomes.