Prenatal risk stratification and novel treatments for abdominal wall defects: Insights From the APSA fetal diagnosis and treatment committee on evolving practice

Gastroschisis and omphalocele are congenital abdominal wall defects frequently diagnosed prenatally. Both occur in ∼1 in 4000 live births, although fetuses with omphalocele have a higher risk of in utero demise, which may affect the reported incidence. Although advances in neonatal intensive care, parenteral nutrition, and surgical techniques have reduced perinatal mortality [1], several challenges remain. In gastroschisis, small constricting defects and bowel exposure to amniotic fluid result in inflammation and dysfunction, and current controversies involve optimal timing of delivery, prenatal risk stratification to distinguish simple from complex disease, and assessment of fetal interventions to improve outcomes.