The influence of gastroschisis on plasmatic coagulation, humoral immunity, and C-reactive protein

Around the 30th week of gestation, patients with gastroschisis (GS) develop chronic inflammatory reactions on the serosal surface of the eventrated loops of intestine that lead to severe hyperfibrinogenemia and hypercoagulability, particularly if they are born prematurely. This result was found on comparison of coagulation studies from 12 patients with GS with those of 4 patients with omphalocele and of healthy premature babies and term infants. Furthermore, the patients with GS showed marked hypogammaglobulinemia, which might also be responsible for the increased numbers of infections complicating the course of this disease. The hypercoagulability increases the risk of thromboembolic complications and disseminated intravascular coagulation, particularly in combination with the surgical closure of the abdominal wall that is undertaken postnatally or with perinatal complications such as asphyxia. Prophylactic therapy with low-dose heparin is indicated.