Gastroschisis is a developmental abnormality of the abdominal wall that occurred during early development. There is no fetal therapy at present for this problem. Present recommendations are for good high risk prenatal care (keep all of your appointments), eliminate factors that might affect growth (smoking), and monitoring of the baby's growth, development and appearance of the gastroschisis with ultrasound. We usually perform ultrasound evaluations at 24 and 28 weeks. If growth and amniotic fluid levels are normal, and there are no concerning findings about the status of the herniated bowel in the gastroschisis, then we have patients return at 32 weeks to begin more intensive surveillence with twice weekly biophysical and non-stress testing and fetal growth assessments every 3 weeks. Fetuses with gastroschisis are at increased risk for intra uterine fetal loss (stillbirth) which is why we start this twice weekly testing early. If the fetus is small for age and has low amniotic fluid volume at the 28 week evaluation, then it is at even higher risk and we begin twice weekly testing at that time. Close monitoring of the gastroschisis and fetal well-being is essential for achieving the best outcome in these pregancies.
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