Anatomy

Obstetrics

Surgery

Fetus

Abdominal wall defect

Umbilical cord

Fetoscopy

Gastroschisis

Prenatal diagnosis

Abdominal wall

Pregnancy

Intestinal atresia

Omphalocele

Atresia

Prenatal ultrasound

Genetics

Medicine

Biology

Seminars in Pediatric Surgery

Gastroschisis is a congenital, ventral wall defect associated with bowel evisceration. The defect is usually to the right of the umbilical cord insertion and requires postnatal surgical correction. The fetus is at risk for complications such as intrauterine growth restriction, preterm delivery, and intrauterine fetal demise. In addition, complex cases, defined by the presence of intestinal complications such as bowel atresia, stenosis, perforation, or ischemia, occur in up to one third of pregnancies affected by gastroschisis. As complex gastroschisis is associated with increased morbidity and mortality, research has focused on the prenatal detection of this high risk subset of cases. The purpose of this review is to discuss the prenatal, diagnostic approach to the identification of gastroschisis, to describe potential signs of complex gastroschisis on prenatal ultrasound, to review current guidelines for antepartum management and delivery planning, and to summarize results of both past and current intervention trials in fetuses with gastroschisis.

Advances in prenatal and perinatal diagnosis and management of gastroschisis