Fetal Gastroschisis

Gastroschisis, a common congenital defect of the abdominal wall, is characterized by varying degrees of visceral herniation of the bowel and may include the stomach, liver, or bladder through a paraumbilical defect. Gastroschisis arises from a complex interplay of early embryonic morphogenetic disruption, vascular compromise, and environmental influences. Though the exact initiating events have yet to be determined, the weight of current evidence supports a model in which defective right-sided body wall formation is compounded by vascular and environmental factors that lead to a paraumbilical full-thickness defect with extruded, uncovered viscera. This Clinical Expert Series provides an overview of embryology, pathophysiology, categorization of complexity, prenatal diagnosis, antenatal monitoring, postnatal surgery, and potential options for fetal intervention for gastroschisis.