"Gastroschisis refers to an extra-abdominal herniation (evisceration) of fetal or neonatal bowel loops (and occasionally portions of the stomach, liver, and/or bladder12) into the amniotic cavity through a para-umbilical anterior abdominal wall defect."
"Antenatal diagnosis of gastroschisis may facilitate a planned delivery in a specialised unit (tertiary care centre) with parental counselling as well as surgical planning. Most infants are treated surgically on the first day of life. In general, it carries a good survival rate of post-surgery 3."
"This anomaly does not have a surrounding membrane (unlike an uncomplicated omphalocele). It is the small bowel that herniates most often. It always herniates through the abdominal wall defect and lacks normal rotation and fixation to the posterior abdominal wall."
"The defect is invariably on the right side and usually measures between 2-4 cm. There is no covering membrane or membrane remnant."
"maternal serum alpha-fetoprotein (MSAFP) may be elevated: the extent of AFP rise is often greater for gastroschisis than for an omphalocele"
Expected headings
"Associations"
"Complications"
"The defect is invariably on the right side and usually measures between 2-4 cm. There is no covering membrane or membrane remnant."
"There are a number of complications which can mainly involve the bowel and include:"
"The herniated content is towards the right side of the umbilical cord in most cases; colour Doppler may be useful to locate the cord in relation to the herniation. This causes the fetal abdominal circumference to be smaller than expected for gestation age. The herniated bowel often appears free-floating rather than contained. The herniated bowel wall can be thickened due to oedema."
"There can be an intrauterine mortality rate of 10-15%. The condition of the bowel at birth is the single most important prognostic factor. Some state that the smaller the gastroschisis, the greater the risk of ischaemia to the herniated gut due to a more severe restriction of blood flow. Antenatal diagnosis of accompanying fetal bowel dilatation (especially if over 20 mm 8) is also considered a poorer outcome. Liver herniation has been reported in up to 6% of patients, conferring a poor prognostic indicator; 43% survival with herniation versus 97% without 11."