Gastroschisis vs Omphalocele

Omphalocele - Herniation of the abdominal contents through an enlarged umbilical opening - Contents includes liver, intestines, stomach, spleen, gallbladder, all of which are covered by the amnion - Defect occurs when there is a failure of the bowel to return to the body cavity during physiological herniation - Physiological herniation is a “normal” type of herniation in the development of the GIT where the intestines rotates outside of the body cavity since there is not enough room for them to grow, subsequent enlargement of the body cavity allows the ingress of the intestines back into the body - 2.5 in 10000 and associated with 25% mortality, severe anomalies including neural tube defects and cardiac defects - Can be detected by US and associated with elevated AFP - Some associations with chromosomal abnormalities

Gastroschisis - Protrusion of the abdominal contents, directly through the body wall into the amniotic cavity and this is why they are not covered by amnion - Does not involve the umbilicus, but is usually occurring to the right of it. - It is due to a failure of normal closure of the body wall around the connecting stalk - Since the protruding organs are not covered by peritoneum or amnion, the bowel may be injured easily by the amniotic fluid - Not associated with chromosome abnormalities, or other severe defects and thus has improved survival rate compared to omphalocele - However these babies are prone to volvulus and subsequent ischaemic gut which may lead to death - Most common in babies born by thin young women less than 20 years - Can be picked up by US - Elevated afp