[Gastroschisis in Iceland, a population study.]
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Introduction:
Gastroschisis, a congenital abdominal wall defect, is a rare disorder. The incidence of gastroschisis in Iceland is neither known nor is the results of surgery.
Objective:
To determine the incidence of gastroschisis in Iceland, treatment results and mortality rate.
Material And Methods:
A retrospective study was performed. Hospital records, birth records and autopsy records were reviewed. The period was divided in two, 1970-1982 and 1983-1994.
Results:
Twenty-eight children with gastroschisis were born in Iceland 1970-1994. Ten children with gastroschisis were born in the first period and 18 in the second, making the incidence 1.78/10,000 births vs. 3.45/10,000 (p<0.09). No abortion was performed because of gastroschisis and no child was stillborn with it. Associated anomalies were detected in 13 children, eight of which were gut atresias or stenosis. Other anomalies were found in seven children (21.4%). Of the mothers 82% (23/28) were primiparous, mean age 21.5 years. Gestational age was 30-40 weeks. Vaginal delivery was in 16 cases and Caesarean section in 12 cases, six of which were elective. Eighteen children were diagnosed at birth, 10 by ultrasound at 19 weeks of gestations. Birth weight was 2650 g (mean, range 1500-3720 g). Primary closure was done in 15 cases and delayed closure in 11, mostly in the first period. Hospital stay was 55 days (mean, median 26 days). Mortality rate was 10.7% (3/28) in two cases associated with major congenital anomalies. Long term complications are few 5/28 and consist of recurrent abdominal pain and constipation.
Conclusions:
This study indicates that the incidence of gastroschisis is increasing in Iceland, and although the study is too small to be significant, the trend is obviously there. In accordance with other studies the predominance of young primiparous mothers and small for gestational age children is observed. The results in treating gastroschisis in Iceland is at least as good as in bigger centers and the mortality rate is well within acceptable range, especially if taken into account that no abortions were performed because of gastroschisis.
