Prenatal diagnosis and management of gastroschisis and omphalocele

Prenatal diagnosis of gastroschisis (GS) and omphalocele (OC) has allowed improved antenatal and perinatal management. It was the aim of this study to compare prenatal findings and assess fetal outcome. Twenty-four fetus with GS and 33 with OC were diagnosed prenatally. Maternal serum alpha-protein (MSAFP), sonographic (US), and perinatal data were analyzed. The average maternal age for GS was younger than for OC (24 vs. 30 years). The median MSAFP values were 7.7 multiples of median for GS and 3.6 for OC. The initial US diagnosis was made at 22 weeks for GS and at 19 weeks for OC. A pathological karyotype was observed in 4% of the fetuses with GS and 33% with OC. The mortality of fetuses with OC was twice as high as that of those with GS. Accurate prenatal diagnosis of GS and OC as well as their differentiation are of crucial importance for both counselling of the parents and the resulting antenatal consequences, and provide the basis for optimal interdisciplinary co-operation at a perinatal tertiary-care center.