Gastroschisis and exomphalos: precise diagnosis by midpregnancy ultrasound

Abstract

As part of a regional screening program for neural-tube defects the cause of the raised .alpha.-fetoprotein levels was correctly identified in 13 pregnancies with a fetal abdominal wall defect by the 22nd wk. Careful ultrasound study identified gastrochisis in 7 fetuses and exomphalos in six; the presence or absence of a sac, the course of the umbilical vessels and the abdominal organs involved were the most important diagnostic criteria. Pregnancy continued into the 3rd trimester in 5 cases complicated solely by gastroschisis and 2 babies have survived the neonatal period following surgical correction. Precise identification by ultrasound of the type and severity of abdominal wall defect and also of the presence or absence of assocaited anomalies will enable the selection of some babies with gastroschisis or isolated exomphalos which have a good prognosis for survival without handicap.