Gastroschisis
Research questions
- 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?
Background
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[1]. The condition has been noted to be increasing worldwide, although the reasons for this rise remain obscure[2]. A number of reports, predominantly from regional congenital anomaly registers, have provided evidence that this increase is also occurring in the UK[1][3][4][5], leading to a call for further research on the condition by the Chief Medical Officer for England[6]. This increase in birth prevalence of gastroschisis has been noted to occur particularly in infants of younger mothers[6]. 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[3]. 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[7]. 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.
Case Definition
All pregnant women with a fetus affected by gastroschisis.
Excluded: Aplasia or hypoplasia of abdominal muscles, skin-covered umbilical hernia or omphalocele.
Study size
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).
Ethics Approval
The study has been approved by the London MREC (study ref 05/MRE02/82).
Ethics approval
The study has been approved by the London MREC (study ref 05/MRE02/83).
Download the Data Collection Form (DCF)
References
- a, b Rankin J, Dillon E, Wright C. Congenital anterior abdominal wall defects in the north of England, 1986-1996: occurrence and outcome. Prenat Diagn 1999; 19(7):662-8.
- ^ Baerg J, Kaban G, Tonita J, et al. Gastroschisis: A sixteen-year review. J Pediatr Surg 2003; 38(5):771-4.
- a, b Stone DH, Rimaz S, Gilmour WH. Prevalence of congenital anterior abdominal wall defects in the United Kingdom: comparison of regional registers. BMJ 1998; 317(7166):1118-9.
- ^ Tan KH, Kilby MD, Whittle MJ, et al. Congenital anterior abdominal wall defects in England and Wales 1987-93: retrospective analysis of OPCS data. BMJ 1996; 313(7062):903-6.
- ^ Chalmers J, Forrest J, Cant B, Hollinsworth M. Congenital anterior abdominal wall defects. Rate of abdominal wall defects is higher in Scotland than England and Wales. BMJ 1997; 314(7077):371-2.
- a, b Donaldson L. On the state of the public health: Annual report of the Chief Medical Officer 2004. London: Department of Health, 2005.
- ^ Boyd PA, Armstrong B, Dolk H et al. Congenital anomaly surveillance in England--ascertainment deficiencies in the national system. BMJ 2005; 330(7481):27.
