3. Antenatal diagnosis

In high-income countries (HICs) routine antenatal scans may detect more than 97% of cases [23]. A diagnosis can be made as early as 10 weeks of gestation [24] and aids counseling, transfer and delivery [25, 26]. Ultrasound will typically pick up herniated bowel not covered by amnion, to the right of the umbilical cord (Figure 2). In contrast, an exomphalos will be covered by a membrane, lies in the

Figure 2. Antenatal scan showing GS.

midline and may involve solid organ prolapse. Ultrasound is instrumental in picking up closing GS which is defined as a worsening ratio of intra vs. extra peritoneal bowel dilatation [27]. Further aids to diagnosis of GS are high levels of maternal serum alpha-fetoprotein (MSAFP) [28], intrauterine growth retardation with or without oligo-/an-hydramnios [7, 29, 30]. As GS is usually an isolated anomaly with very few risks to the mother or child, termination of pregnancy is not habitually offered [2, 31, 32].
