TY - JOUR T1 - Prognosis in isolated gastroschisis with bowel dilatation: a systematic review JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed DO - 10.1136/adc.2008.140434 AU - Clare L Tower AU - Stephen SC Ong AU - Andy K Ewer AU - Khalid Khan AU - Mark D Kilby Y1 - 2008/11/10 UR - http://fn.bmj.com/content/early/2008/11/10/adc.2008.140434.abstract N2 - Objectives: To investigate prognosis of the fetus with isolated gastroschisis and bowel dilatation from a systematic review of the literature. We aimed to compare the incidence of a) intrauterine death b) death within 4 weeks of delivery c) bowel resection, d) length of time to oral feeds, e) time as inpatient in fetuses with gastroschisis with and without evidence of bowel dilatation. Methods: Literature was identified by searching two bibliographical databases between 1980 and 2007. Studies were assessed for quality and stratified according to the definition of bowel dilatation. The data extracted was inspected for clinical and methodological heterogeneity. Results: The search strategy yielded 1335 potentially relevant citations. Full manuscripts were retrieved for 92 citations. 10 studies (273 patients) were finally included in the systematic review. No difference was found between groups for death within 4 weeks of delivery (OR = 0.62; (95% CI 0.11 to 3.32); heterogeneity p = 0.39) or bowel resection (OR = 3.35 (95% CI 0.82 to 13.74); heterogeneity p = 0.39). There was insufficient data to compare the risk of intrauterine death and length of time to oral feeds. The mean inpatient stay was not significantly different (OR =16.63; (95% CI 0.98 to 32.28); heterogeneity p = 0.23). Conclusion: Current available evidence suggests that fetuses with isolated gastroschisis and bowel dilatation are not at increased risk of adverse perinatal outcome, compared to those without bowel dilatation. However, there is a paucity of studies, and a randomised controlled trial is urgently needed. ER -