VP09.22: Prenatal diagnosis of gastroschisis and primary closure

Abstract

Gastroschisis is a defect of the fetal abdominal wall lateral to the umbilical cord insertion, with extrusion of abdominal organs, mainly the bowels, let them in direct contact with the ambiotic fluid. Prevalence 1/2,000–3,000. Etiology is unclear. Associated to maternal age <20 and the use of alcohol, tobacco and cocaine and drugs AAS, ibuprofen,ephedrine. Low association with other anomalies. 20–40% complicated with SGE. 25% oligohydramnios. 5–10% exitus. 10–25% bowel complications: torsion, oclusion, perforation, ischemia. Prenatal diagnosis can be done in the first trimester ecography. Case: IPC 31 years old, GI, LMP: 10 Feb 2019. First trimester screening: 15 May 2019. Single pregnancy 13.4 wks by CCL; NT 1.3mm, NB present, DV normal; low risk; abdominal wall defect lateral and right side of the umbilical cord insertion, with protusion of intestinal loops; no other anomalies detected. Morphologic scan: 18 Jul 2019 at 22–23 wks no other malformations. Prenatal care every 2 wks until 35 wks when dilation of intestinal loops is observed. Caesarean section: 18 Oct 2019 at 35.5 wks; male 2,200g, Apgar 8/9. Neonatal surgery team decide primary closure. In conclusion, isolated, survival rate >90%; neonatal morbidity and mortality are associated with intestinal complications. Bad prognosis findings: dilation of the extraabdominal intestinal loops >10mm, dilation of intraabdominal intestinal loops, polihydramnios. There is some recomendation about ending the pregnancy before 36 weeks in order to minimise peel injury. The primary closure allowed decreased hospitalisation, reduce complications and neonatal mortality. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.