Advances in prenatal and perinatal diagnosis and management of gastroschisis

Area of Science:

• Medical Science
• Fetal Medicine
• Neonatal Surgery

Background:

• Gastroschisis is a congenital ventral wall defect with bowel evisceration, typically left untreated until after birth.
• Fetuses with gastroschisis face risks including intrauterine growth restriction, preterm birth, and fetal demise.
• Complex gastroschisis, involving intestinal complications, affects up to one-third of cases and increases morbidity and mortality.

Purpose of the Study:

• To review the prenatal diagnostic approach for identifying gastroschisis.
• To describe ultrasound markers for detecting complex gastroschisis.
• To outline current antepartum management, delivery planning, and intervention trial outcomes for gastroschisis.

Main Methods:

• Review of existing literature on gastroschisis diagnosis and management.
• Analysis of prenatal ultrasound findings associated with complex gastroschisis.
• Synthesis of guidelines for antepartum care and delivery strategies.
• Summary of results from relevant intervention trials.

Main Results:

• Prenatal ultrasound plays a crucial role in identifying gastroschisis and its complexity.
• Specific ultrasound signs can indicate the presence of intestinal complications.
• Established guidelines aid in optimizing antepartum management and delivery planning.
• Intervention trials offer insights into improving outcomes for affected fetuses.

Conclusions:

• Accurate prenatal diagnosis of gastroschisis, particularly complex cases, is essential for improving fetal outcomes.
• Ultrasound assessment guides risk stratification and informs management decisions.
• Evidence-based guidelines and ongoing research contribute to better care for fetuses with gastroschisis.