Diagnostic ultrasound ( PDFDrive )

1324 PART IV Obstetric and Fetal Sonography
B
Sp
A
B
SB
External loops
of bowel
C
D
E
FIG. 38.29 Gastroschisis. (A) Schematic of the full-thickness
abdominal wall defect lateral to the umbilical cord. (B) Transverse
color Doppler image at the level of the abdominal umbilical cord
insertion (arrow) in a 20-week fetus shows free-loating loops of
bowel (arrowheads) in the amniotic luid to the right of the cord
insertion site. B, Bladder; Sp, spine. (C) Sagittal view of a fetus with
gastroschisis with bowel (arrow) visible between the legs. (D)
Gastroschisis with dilated intraabdominal loops of small bowel (SB).
This fetus was born with torsion of loops of bowel at the cord insertion
site, but they were able to be reduced without requiring bowel
resection. (E) Gastroschisis with dilated loops of bowel loating in
the amniotic luid. See also Video 38.12.
to amniotic luid. Dilated loops of bowel may be seen either
within or outside the abdomen due to associated bowel obstruction
secondary to the small abdominal opening or associated
volvulus. he stomach is oten displaced downward within the
abdominal cavity. he umbilical cord inserts normally into the
abdomen, adjacent to but separate from the defect. Less oten
the defect extends upward or laterally and may include structures
other than the intestine, such as liver and stomach.
Associated Conditions
Associated GI abnormalities such as atresias, stenosis, perforations,
or volvulus are reported in 11% to 31% of cases. 180,202,203 Many
of these associated GI conditions are believed to be the result
of gastroschisis. 204,205 Additional non-GI anomalies are less
common. 202-204,206-208 he risk of aneuploidy in cases of isolated
gastroschisis is similar to that of the general population. 191,202,206,207
An increased risk of preterm birth, fetal growth restriction (up