What causes pediatric omphalocele and gastroschisis (abdominal wall defects)?

Updated: Nov 05, 2019
  • Author: James G Glasser, MD, MA, FACS; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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Answer

In rat studies, folic acid deficiency, hypoxia, and salicylates cause abdominal wall defects to develop, but the clinical significance of these experiments is conjectural.

Elevation of maternal serum alpha-fetoprotein (MSAFP) is associated with omphalocele and gastroschisis. An elevated MSAFP warrants ultrasonographic evaluation to determine if structural abnormalities are present in the fetus. If the study is suspicious for an omphalocele, amniocentesis is indicated to determine the presence of an associated genetic abnormality.

Polyhydramnios occurs in association with intestinal atresia, which may complicate gastroschisis. If polyhydramnios is identified by fetal ultrasonography, the mother should be referred to a tertiary care facility for optimal care of her newborn. Generally, newborns requiring surgery are best managed at tertiary care centers.


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