Abstract
Gastroschisis is a malformation of the closure of the anterior abdominal wall which has had a growing incidence in recent years. It is a borderline pathology between several specialties such as: obstetrics, neonatology, pediatric surgery, family medicine and requires many resources. In general, the chance of survival of newborns with gastroschisis is high. However, complex cases with complications are more likely to have an unfavorable prognosis. The therapeutic plan should start from the intra-embryonic period, from the time of the ultrasound diagnosis and it should extend over a long period of time, which can vary depending on the case, and on the surgical options. When it comes to the management of the cases, there is no valid protocol for all the cases, and there is a great variability starting with the choice of birth time, birth pathway, the option of reintegrating the intestinal loops and closing the abdominal defect. Because of this, the cases of gastroschisis represent a challenge for modern medicine, when also taking into account the fact that the etiopathogenesis of this malformation is not clearly established and that there is a large variety of therapeutic options.
Highlights
Gastroschisis is the most frequent developmental defect of the anterior abdominal wall
According to a recent global multinational study [8], among gastrointestinal anomalies, mortality prognosis of gastroschisis depend on country income strata
In high-income countries, survival rates exceed 90% [9], but the treatment used, starting from the childbirth technique, the early postnatal management, the closure technique and nutritional support requires a large amount of resources which causes this pathology to be among the most expensive in neonatal intensive care units (NICUs) [8,10]
Summary
Gastroschisis is the most frequent developmental defect of the anterior abdominal wall. It is a periumbilical abdominal wall defect that results in the herniation of abdominal structures (usually bowel, but it is rarely associated with liver herniation) out of the abdominal cavity. The malformation is dangerous for the fetus because of the exposure of the intestinal loops to amniotic fluid in utero and the complications that might arise in the extrauterine life.
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