Increased incidence of cardiac anomalies in pregnancies complicated by gastroschisis

Associated malformations and the “hidden mortality” of gastroschisis

“…After a rigorous process of exclusion of nongastroschisis abdominal wall defects and secondary gastroschisis defects, the study identified 469 cases (14.1%) of nonisolated gastroschisis, which included 41 chromosomal syndromes, 24 "other" syndromes, and 404 cases of multiple congenital anomalies. Other registries report similarly distributed primary malformation rates of 17% [17], 27% [13], 23% [20], and, in one study confined to associated congenital heart defects unrelated to persistent fetal circulation, 4% [21].…”

“…Associated chromosomal malformations include trisomies [12,13,16,18,21,30] and Turner syndrome [31]. Other reported associations include neural tube defects [16,17,20], hydrocephalus [16,17,21], and anorectal malformations including imperforate anus [16,17] and Hirschsprung's disease [32,33].…”

“…Cardiac defects (exclusive of PDA) associated with gastroschisis include septal defects, tetralogy of Fallot, Ebstein anomaly, aortic coarctation, double-outlet right ventricle, transposition of the great arteries, and pulmonic outflow obstruction [12,20,21]. Facial malformations reported in co-occurrence with gastroschisis include facial clefting [16,[20][21][22][23] and oromandibular limb hypogenesis syndrome [24,25].…”

Gastroschisis with intestinal atresia—predictive value of antenatal diagnosis and outcome of postnatal treatment

“…It was first identified at a median of 33 4 weeks (range, 21 0 -37 3 ) and median gestational age at delivery was 36 6 weeks (31 4 -39 0 ) ( Table 1). Fetal bowel dilatation onset was at a median of 30 5 weeks (range, 21 0 -35 6 ) in the atresia group and 34 0 weeks (range, 21 0 -37 3 ) in the nonatresia group. Seventeen cases (13%) had a dilated stomach detected on ultrasound, and 3 were subsequently diagnosed with atresia.…”

Gastroschisis associated with cleft lip and palate

“…As the incidence of gastroschisis increases, more midline defects are being reported, including one case of sternal cleft [13]. Cardiac anomalies have also been recently reported in cases of gastroschisis [14]. Although there is no doubt that chromosomal and midline anomalies such as cleft palate are more common with omphalocele, these cases might challenge the theory that midline defects are associated only with omphalocele as part of midline syndromes.…”