Which prenatal abdominal wall defect involves all layers of the abdominal wall, is associated with markedly elevated AFP, and features free-floating bowel in the amniotic cavity to the right of the umbilical cord?

Which prenatal abdominal wall defect involves all layers of the abdominal wall, is associated with markedly elevated AFP, and features free-floating bowel in the amniotic cavity to the right of the umbilical cord?

• A. Gastroschisis
• B. Omphalocele
• C. Sacrococcygeal teratoma
• D. Renal agenesis

Answer: (A)

Gastroschisis is a true, full-thickness abdominal wall defect that lies to the right of the umbilicus, exposing bowel to the amniotic fluid. Because the abdominal contents aren’t covered by a sac, the fetal intestines float freely in the amniotic cavity and AFP levels in both amniotic fluid and maternal serum become markedly elevated. This combination—open, all-layer defect with free-floating bowel on ultrasound and high AFP—distinguishes gastroschisis from other entities. Omphalocele, for example, involves herniated contents that are contained within a membrane at the umbilicus, not free-floating and not typically right of the cord. Sacrococcygeal teratoma is a mass at the coccyx, and renal agenesis is not an abdominal wall defect at all.

Gastroschisis is a true, full-thickness abdominal wall defect that lies to the right of the umbilicus, exposing bowel to the amniotic fluid. Because the abdominal contents aren’t covered by a sac, the fetal intestines float freely in the amniotic cavity and AFP levels in both amniotic fluid and maternal serum become markedly elevated. This combination—open, all-layer defect with free-floating bowel on ultrasound and high AFP—distinguishes gastroschisis from other entities. Omphalocele, for example, involves herniated contents that are contained within a membrane at the umbilicus, not free-floating and not typically right of the cord. Sacrococcygeal teratoma is a mass at the coccyx, and renal agenesis is not an abdominal wall defect at all.