Omphalocele and Gastroschisis

Abstract

Omphaloceles and gastroschises are the most common congenital abdominal wall defects. The incidence of omphaloceles is 1:3000–4000 births in western countries (Wilson and Johnson, Fetal Diagn Ther 19:385–398, 2004). The incidence of gastroschises is between 1.10/10,000 and 5.1/10,000 (Zaccara et al., J Pediatr Surg 38:478–481, 2003). There is a rising incidence of both gastroschisis and omphalocele (Fig. 41.1). For gastroschisis, it is secondary to improved antenatal monitoring (Fig. 41.2) and increased interaction with environmental factors (Jones et al., Clin Genet 74:322–325, 2009). It appears to affect babies born to young, first-time mothers with low socioeconomic status and poor maternal diet (Goldbaum et al., Teratology 42:397–403, 1990; Siega-Riz et al., Paediatr Perinat Epidemiol 23:51–57, 2009). Omphalocele is seen more commonly in mothers at the two ends of the reproductive age and babies born with assisted conception (Kong et al., J Pediatr Surg 51:1644–1649, 2016). The complexity of omphaloceles and gastroschises can vary greatly, affecting perioperative care. Strategies for repair have evolved. Both require significant attention and stabilization before surgical intervention.