• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
OB
CMECNE

Gastroschisis – Detection and Implications

image_pdfFavoriteLoadingFavorite

Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. Contrast gastroschisis to an omphalocele
2. Outline the steps to take after gastroschisis is diagnosed on sonogram

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2021, participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

WHAT IS IT? 

  • Gastroschisis is the presence of intestinal loops in the amniotic cavity due to failure of abdominal body wall closure, typically to the right of the umbilicus
  • There is no membrane covering the protruding organs, therefore organs are exposed to amniotic fluid and can be damaged
  • Incidence 1/1800 births per year in USA
  • Chromosomal abnormalities are not typically associated, unlike omphalocele
    • One international study reported chromosomal anomalies in 1.2% (total 3,322 cases) with the most frequent being
      • Trisomy 18 (15 cases) | Trisomy 13 (14 cases) | Sex chromosomes anomalies (4 cases) | Trisomy 21 (2 cases)

KEY CLINICAL POINTS:

  • Cause of gastroschisis unknown in most cases
  • Associations have been demonstrated with maternal history of
    • Young age and thin body type
    • Primipara or primigravida females
    • Cigarette smoking in pregnancy
    • Poor maternal diet
    • Low socioeconomic status
    • Maternal use of certain medications (phenylpropanolamine and pseudoephedrine decongestants, salicylates, ibuprofen, acetaminophen)
  • Prenatal screening and detection is available
    • Maternal serum AFP (MSAFP) is elevated
    • Amniotic fluid AFP (AFAFP) is elevated
    • Possible polyhydramnios detected on prenatal ultrasound
  • If gastroschisis is detected on ultrasonography 
    • ACOG guidance recommends offering invasive testing using microarray in the setting of fetal structural anomalies seen on prenatal ultrasound
    • Fetal echocardiography referral
    • Ensure detailed anatomy ultrasound that includes visualization of all limbs, to rule out potential syndrome associated with body-stalk disruption
      • Note abdominal opening to the right of the umbilicus
    • Minimal recurrence risk 2.5%
  • Refer to Pediatric surgical specialist to discuss possible surgical correction options, outcomes and long term implications
  • Develop labor and delivery plan for those who will continue the pregnancy given its high risk nature, and coordinate with NICU and pediatric team as needed
  • Data suggests better outcomes at perinatal centers that also include surgical teams capable of definitive operative management and NICU availability
Gastroschisis

Image credit: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities


Want to hear about the latest clinical summaries via ObG Insider?

Get Your Free e-Newsletter »


Learn More – Primary Sources:

CDC: Facts about Gastroschisis

Gastroschisis and associated defects: an international study

Review of Abdominal Wall Defects

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

Gastroschisis: antenatal sonographic predictors of adverse neonatal outcome

Influence of location of delivery on outcome in neonates with gastroschisis

Locate a Maternal Fetal Medicine Specialist:

Maternal-Fetal Medicine Specialist Locator-SMFM

Take a post-test and get CME credits

TAKE THE POST TEST

2nd Trimester Ultrasound Reference Library, Now Available on Your Phone with ObGFirst

Learn More  »

image_pdfFavoriteLoadingFavorite

< Previous
All OB Posts
Next >

Related ObG Topics:

Practical obstetrics info for your women's healthcare practice
Omphalocele – An Early Ventral Wall Defect
Practical obstetrics info for your women's healthcare practice

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site