Effect of Amnioinfusion on the Outcome of Prenatally Diagnosed Gastroschisis

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Abstract
Objective: Following recent data showing that an inflammatory response exists in the amniotic fluid of gastroschisis-affected fetuses, we hypothesized that amniotic fluid exchange or amnioinfusion would improve the prognosis of prenatally diagnosed gastroschisis. Methods: We compared the outcome of prenatally amnioinfused fetuses with gastroschisis to non-amnioinfused fetuses with gastroschisis. 10 patients undergoing this procedure were matched with 10 patients of our previous study. Comparisons were done on data including surgical procedure, follow-up in the NICU and the gastro-pediatric unit. Results: Our results show that gastroschisis-affected fetuses undergoing amnioinfusion had a lower duration of curarization after surgery (2.2 ± 1.9 vs. 6.8 ± 6.9 days, p = 0.019), a shorter delay before full oral feeding (49.7 ± 21.5 vs. 72.3 ± 56.6 days, NS), and a shorter overall length of hospitalization (59.5 ± 19.7 vs. 88.5 ± 73.6 days, NS). We confirmed our previous data showing that amniotic fluid displays a chronic inflammation profile. Conclusion: Our data suggest that amnioinfusion could improve the outcome of gastroschisis affected fetuses. The hypothesis by which this improvement could be due to a reduction of an inflammatory response remains to be proved.