**6.1. Gastroschisis**

bowel or total abdominal contents, evisceration. There is a pleural and pericardial effusion and the fetal heart is completely external or just partially. The prognosis is fatal and the survival is uncommon. Prenatal diagnosis is important as termination of pregnancy is the only

The ultrasound features that best characterize fetal AWDs are presented in **Figure 5** [26].

In cases with abdominal wall defects, fetal distress was reported in 43% of cases, with an abnormal neurological outcome in 16% of them [111]. There is also the risk of still birth, reported to be 11% in cases of gastroschisis and 20% in cases of omphalocele [112]. Fetuses with gastroschisis often tend to be small for gestational age and to develop oligohydramnios [113, 114]. In such cases, the assessment of fetal weight can be difficult, as measurements of the fetal abdomen are not valid [115]. Placental insufficiency can be indirectly estimated by umbilical artery Doppler velocimetry, cardiotocography and biophysical profile. Still,

option for the couple.

**4. Pregnancy surveillance**

**Figure 5.** Ultrasound findings in fetal abdominal wall defects [26].

218 Congenital Anomalies - From the Embryo to the Neonate

Postpartum, fetuses with gastroschisis must benefit from intravenous fluid resuscitation and wrapped herniated loops in warm saline as there is an increased risk for water and heat losses by evaporation. Specialized management of gastroschisis includes repositioning of the herniated bowel into the abdominal cavity, with closure of the abdominal wall (primary reduction and repair). In such cases, there is a high risk of respiratory complication. The surgical procedure can be also postponed if the patient is unstable [18], but with subsequent longer time to reach full enteral feeds. In cases of complex gastroschisis, the repair is usually delayed, as anastomosis is impossible immediately after delivery, having an inherent risk of infectious and cholestasis complications [18, 24].

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