title: Gastroschisis--what should be told to parents?
abstract: Gastroschisis is a common congenital abdominal wall defect. It is almost always diagnosed prenatally thanks to routine maternal serum screening and ultrasound screening programs. In the majority of cases, the condition is isolated (i.e. not associated with chromosomal or other anatomical anomalies). Prenatal diagnosis allows for planning the timing, mode and location of delivery. Controversies persist concerning the optimal antenatal monitoring strategy. Compelling evidence supports elective delivery at 37  weeks' gestation in a tertiary pediatric center. Cesarean section should be reserved for routine obstetrical indications. Prognosis of infants with gastroschisis is primarily determined by the degree of bowel injury, which is difficult to assess antenatally. Prenatal counseling usually addresses gastroschisis issues. However, parental concerns are mainly focused on long-term postnatal outcomes including gastrointestinal function and neurodevelopment. Although infants born with gastroschisis often endure a difficult neonatal course, they experience few long-term complications. This manuscript, which is structured around common parental questions and concerns, reviews the evidence pertaining to the antenatal, neonatal and long-term implications of a fetal gastroschisis diagnosis and is aimed at helping healthcare professionals counsel expecting parents.
authors.affiliation: Materno-fetal & Obstetrics Research Unit, Department of Obstetrics and Gynecology, University Hospital, 1011, Lausanne, Switzerland.
authors.forename: Karine
authors.initials: K
authors.lastname: Lepigeon
authors.forename: Tim
authors.initials: T
authors.lastname: Van Mieghem
authors.forename: Sabine
authors.initials: S
authors.lastname: Vasseur Maurer
authors.forename: Eric
authors.initials: E
authors.lastname: Giannoni
authors.forename: David
authors.initials: D
authors.lastname: Baud
mesh_terms: D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D020139:Gastroschisis / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D010290:Parents / Q000193:education*; D010353:Patient Education as Topic; D011247:Pregnancy; D011379:Prognosis; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal