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Updated: Sep 1, 2026

A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
Published on: December 20, 2014
Abdominal wall defects and obstructive uropathies. Aetiology and management
1Department of Surgery, Wellington School of Medicine, New Zealand.
Insights
Gastroschisis and omphalocele are distinct birth defects with unique anomalies. Management strategies for these conditions, including delivery and in utero interventions for associated renal dysplasia, are discussed, highlighting the need for further research.
Area of Science:
- Developmental biology
- Perinatal medicine
- Pediatric surgery
Background:
- Gastroschisis and omphalocele are distinct congenital abdominal wall defects.
- Each condition presents with a unique set of associated anomalies.
- Current literature presents controversies regarding optimal perinatal management and antenatal diagnosis.
Purpose of the Study:
- To review and discuss the perinatal management of gastroschisis and omphalocele.
- To explore controversies surrounding the etiology of renal dysplasia and its association with urinary tract obstruction.
- To outline therapeutic options and indications for in utero shunting procedures.
Main Methods:
- Literature review and synthesis of existing research on gastroschisis and omphalocele.
- Discussion of controversies in perinatal management, delivery modes, and antenatal diagnosis.
- Analysis of etiological factors and treatment options for renal dysplasia, including in utero interventions.
Main Results:
- Gastroschisis and omphalocele, though both abdominal wall defects, are embryologically distinct.
- Management strategies address controversies in delivery methods and antenatal diagnosis.
- The etiology of renal dysplasia and the utility of in utero shunting remain areas of debate.
Conclusions:
- Emphasizes the need for prospective randomized trials to resolve management controversies.
- Highlights the challenges in selecting appropriate indices for treatment decisions in trials.
- Stresses the importance of long-term follow-up for all patients in such trials.
Abstract:
Gastroschisis and omphalocele (exomphalos) are embryologically distinct, and for this reason each has its own distinct constellation of associated anomalies. The perinatal management of both gastroschisis and omphalocele addresses the controversy as to the best mode of delivery that has been expressed in the literature with regard to gastroschisis and has exercised many of those involved in antenatal diagnosis in the case of omphalocele. The post-delivery management of both of these defects is briefly discussed. Controversies surrounding the aetiology of renal dysplasia and whether urinary tract obstruction is a cause of dysplasia or an anomaly associated with dysplasia are also discussed. The options for therapy and the indications for an in utero shunting procedure are outlined as well as the controversy centred around the utility of an in utero shunt. The need for a prospective randomised trial is emphasised, together with the difficulty that is raised by the need to choose a limited number of prospective indices on which treatment decisions in such a trial must be based. The need for a long-term follow-up of all patients entered in such a trial is emphasised.
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