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Early onset Marfan syndrome is the most severe form of Marfan syndrome diagnosed during perinatal period. Early onset Marfan syndrome is associated with high mortality rates, usually within the first 2 years of life. First, we present a case of prenatally diagnosed early onset Marfan syndrome in a dichorionic diamniotic twin pregnancy, where suspicion was raised at 35 weeks of gestation. Ultrasound and fetal magnetic resonance imaging were used to assess prenatal findings in the affected fetus. She presented right diaphragmatic eventration, elongation of humerus and femur and subluxation of the crystalline lens. She died 3 months after birth. Secondly, we present a PubMed-based review of the published articles on early onset Marfan syndrome, with pre- or postnatal suspicion or diagnosis. We found 39 articles published between 1981 and 2017, arising information on 55 cases. Including ours, early onset Marfan syndrome was prenatally diagnosed in 34.54% of the cases. In these cases, the most frequent prenatal findings were cardiomegaly, dilatation of the great vessels and mitral or tricuspid regurgitation. Mortality rate during the first 15 months after birth was 73.68%. In the postnatally diagnosed cases, the most frequent findings were arachnodactyly, dilatation of the great vessels and mitral or tricuspid regurgitation. Mortality rate was 61.11%. Overall genetic confirmation was performed in 67.27% of the cases. Prenatal diagnosis of early onset Marfan syndrome is challenging but of utmost importance, since management should take place in a tertiary care center, by a multidisciplinary team. Differential diagnosis is essential in order to perform an adequate genetic counseling.

We describe the synthesis and characterization of a new N-methylpyrrolidine-fused meso-tetracarboxyphenylchlorin with highly emissive features. The synthetic approach to obtain the fluorescent chlorin involves the microwave-assisted synthesis of meso-tetrakis (4-methoxycarbonylphenyl)porphyrin, followed by a 1,3-dipolar cycloaddition reaction of this porphyrin with azomethine ylide and, finally, ester hydrolysis under basic conditions. The incorporation and anchoring of the chlorin to a nanostructured porous TiO2 matrix is achieved and optimized for its use as a fluorescent sensor. In particular, we found an efficient detection of the explosive triacetone triperoxide (TATP) in the gas phase. The optical response after analyte exposure is selective and fast, with response time t50 values of less than 10 min under exposure to TATP saturated vapours.

Key Clinical Message Bardet–Biedl syndrome (BBS) is a ciliopathy that is responsible for multiple visceral abnormalities. This disorder is defined by a combination of clinical signs, many of which appear after several years of development. BBS may be suspected antenatally based on routine ultrasound findings of enlarged hyperechogenic kidneys and postaxial polydactyly.

In this work, ultraviolet-visible reflection spectroscopy is proposed as a technique that, in combination with classical surface pressure–area isotherms, allows to study in situ the adsorption of DNA to octadecylamine monolayers. The presence of the polynucleotide molecules at the interface, typically demonstrated by an expansion and a change in the profile of the ODA isotherms, has been confirmed here by a reflection peak at 260 nm. Increasing DNA concentrations in the subphase from 2 to 8 μM is accompanied by an increment in the expansion of the isotherm showing in all cases an abrupt phase transitions at high surface pressures that is also observed in lateral compressibility representations. This phase transition has been attributed to a squeezing out of DNA phenomenon as demonstrated by the normalization of the corresponding reflection spectra. In addition, hysteresis and reversibility in the formation of the monolayer has been identified, making possible the realization of successive compression–decompression cycles without reaching the collapse of the monolayer. It can be inferred that the DNA molecules expelled out of the monolayer at high surface pressures can enter again during the decompression process. Reflection spectroscopy has been also found to be a valuable tool to investigate the dependence of the adsorption process with both time and DNA concentration in the subphase.

Aortic arch anomalies are present in 1% to 2% of the general population and are commonly associated with congenital heart disease, chromosomal defects, and tracheaesophageal compression in postnatal life. The sonographically based detection of aortic arch anomalies lies in the 3-vessel and trachea view. Although highly sensitive, this view alone does not allow identification of the aortic arch branching pattern, which prevents an accurate diagnosis. The systematic addition of a subclavian artery view as part of a standardized procedure may be useful in the differential diagnosis of these conditions. We describe the sonographic assessment of fetal aortic arch anomalies by combining 2 fetal transverse views: the 3-vessel and trachea view and the subclavian artery view, which are included in the cardiovascular system sonographic evaluation protocol. We also review the sonographic findings and the clinical implications of fetal aortic arch anomalies.

A double aortic arch is a relatively uncommon anomaly occasionally associated with congenital heart disease or the chromosome 22q11 deletion. We report a case of prenatal diagnosis of a double aortic arch in which the sonographic features in the 3-vessel and trachea view are highlighted. A PubMed-based search was made to retrieve all cases of prenatal diagnosis of double aortic arch. A total of 13 articles and 35 cases were found. The average gestational age at diagnosis was 29 weeks. Six cases had associated cardiac anomalies. Only 1 case had the 22q11 deletion, showing extracardiac anomalies without cardiac defect. The postnatal evolution was characterized by symptoms of tracheoesophageal compression in 72.4% of the cases. Detection of a double aortic arch should be followed by a thorough fetal scan and echocardiography, and a chromosomal study should be considered when the sonographic findings are consistent with the 22q11 deletion.

Objectives - To evaluate the reproducibility and feasibility of the new cardiovascular system sonographic evaluation algorithm for studying the extended fetal cardiovascular system, including the portal, thymic, and supra-aortic areas, in the second trimester of pregnancy (19-22 weeks). Methods - We performed a cross-sectional study of pregnant women with healthy fetuses (singleton and twin pregnancies) attending our center from March to August 2011. The extended fetal cardiovascular system was evaluated by following the new algorithm, a sequential acquisition of axial views comprising the following (caudal to cranial): I, portal sinus; II, ductus venosus; III, hepatic veins; IV, 4-chamber view; V, left ventricular outflow tract; VI, right ventricular outflow tract; VII, 3-vessel and trachea view; VIII, thy-box; and IX, subclavian arteries. Interobserver agreement on the feasibility and exploration time was estimated in a subgroup of patients. The feasibility and exploration time were determined for the main cohort. Maternal, fetal, and sonographic factors affecting both features were evaluated. Results - Interobserver agreement was excellent for all views except view VIII; the difference in the mean exploration time between observers was 1.5 minutes (95% confidence interval, 0.7-2.1 minutes; P < .05). In 184 fetuses (mean gestational age ± SD, 20 ± 0.6 weeks), the feasibility of all views was close to 99% except view VIII (88.7%). The complete feasibility of the algorithm was 81.5%. The mean exploration time was 5.6 ± 4.2 minutes. Only the occiput anterior fetal position was associated with a lower frequency of visualization and a longer exploration time (P < .05). Conclusions - The cardiovascular system sonographic evaluation algorithm is a reproducible and feasible approach for exploration of the extended fetal cardiovascular system in a second-trimester scan. It can be used to explore these areas in normal and abnormal conditions and provides an integrated image of extended fetal cardiovascular anatomy.

Objectives - The purpose of this study was to estimate reference ranges for the pulsatility index (PI) of the fetal aortic isthmus in uncomplicated singleton and twin pregnancies during the second half of pregnancy. Methods - We conducted a cross-sectional observational study involving 543 healthy fetuses: 361 singleton pregnancies and 182 twin pregnancies between 19 and 36 weeks' gestation. The aortic isthmus PI was measured in 2 sonographic planes: the longitudinal aortic arch view and the 3-vessel and trachea view. We evaluated the reproducibility of aortic isthmus PI measurements between these planes by calculating intraclass correlation coefficients and limits of agreement. Scans were performed by 2 physicians, and intraobserver agreement was also measured. Regression analysis was used to estimate gestational age reference values for the aortic isthmus PI. Results - The aortic isthmus PI was significantly correlated with gestational age in singletons and twins during the second half of pregnancy (P < .01). We did not find significant differences between reference ranges in singletons and twins or between the sonographic views. Conclusions - This study offers reference ranges for the aortic isthmus PI during the second half of gestation in singleton and twin pregnancies. Mean aortic isthmus PI values were similar in both types of gestations as well as both sonographic views. The aortic isthmus PI may be reliably obtained from either sonographic view.

Congenital double aortic arch (DAA) is an uncommon vascular anomaly; however, its prenatal detection is associated with congenital heart defects and chromosomal abnormalities, including 22q11 deletion. We present a case of DAA diagnosed prenatally. DAA can be diagnosed by prenatal ultrasound in the transverse three vessel-trachea view, which shows a trident image formed by a complete vascular ring and the ductus arteriosus. Postnatal magnetic resonance images in this view correlate well with prenatal ultrasound images and help in confirmation of diagnosis, evaluation of the risk of airway or esophageal compression, and planning of surgery.

Prenatal ultrasound is the standard for the diagnosis of fetal anomalies. However, fetal MRI has emerged as a valuable diagnosis tool to complete the study of fetal malformations. Type II single umbilical artery results from the absence of both umbilical arteries and persistence of the vitelline artery. It has been described only in fetuses with sirenomelia or caudal regression syndrome. We report a favorable outcome in a normal fetus in which prenatal ultrasound and MRI showed a single umbilical artery arising from the aorta. The etiology of such a finding and its possible consequences are discussed.J. Magn. Reson. Imaging 2013;38:951–954. © 2013 Wiley Periodicals, Inc.

Objective Our aim was to describe ultrasound findings and perinatal outcome after prenatal diagnosis of persistent right umbilical vein (PRUV). Study design We performed a retrospective analysis of fetuses with an ultrasound-based prenatal diagnosis of PRUV on record at 2 tertiary centers in Madrid, Spain. We describe clinical, maternal, fetal and perinatal variables for all cases. Results A total of 20,426 fetuses were delivered between the study centers. We detected 22 cases (0.1%) of PRUV. The male-to-female ratio was 1:1. All cases were intrahepatic type and diagnosed during the second and third trimesters (median, 21 weeks; IQR, 20–29 weeks). Doppler ultrasound revealed normal flow in the ductus venosus in all cases. Nine fetuses (40.9%) had additional ultrasound anomalies but no chromosomal abnormalities. Cardiovascular malformations were the most frequently associated congenital anomalies (4/9), followed by neurological malformations (2/9). In 5 of the cases with no concomitant anomalies, the weight of the newborn was below the tenth percentile for gestational age. Gestational development was normal for the remaining newborns. Delivery was unremarkable, and post-natal evolution was favorable. Conclusion Our results point to a potential association between PRUV and other fetal malformations and a very low rate of chromosomal abnormalities. Prenatal diagnosis of PRUV should be followed by detailed anatomical evaluation and echocardiography in order to rule out other structural malformations. The indication for a fetal karyotype study must be made on an individual basis considering PRUV type and other ultrasound findings.

Objective To evaluate the perinatal outcome of selective termination in dichorionic twins discordant for congenital defect, performed at the Hospital General Universitario Gregorio Maranon. Study design Twenty-eight dichorionic twins with an anomalous fetus were included from May 2008 to February 2011. Intracardiac KCl (1–2 ml; 15 mEq/ml) under ultrasonographic guidance was used in all procedures. Congenital defect, gestational age at the procedure, incidence and perinatal outcome were retrieved. Results Selective termination was performed in 14 (50%) cases of structural defects with normal karyotype and in 14 (50%) cases of chromosomal abnormality, 13 of them (92.8%) trisomy 21. Median gestational age at the procedure was 17.8 weeks (range 14.5–24; SD 2.3), and 12 (42.8%) were performed before 18 weeks. The presenting fetus was terminated in 11 cases (39.3%). Selective termination was followed by the subsequent delivery of a viable infant in 27 out of 28 cases (96.4%). Fetal loss before 24 weeks occurred in 1 case (3.6%). Median gestational age at delivery was 38 weeks (range 24.1–40.1; SD 3.8). Twenty-four (88.9%) were delivered >34 weeks and 1 (3.7%) before 28 weeks. Conclusion Selective termination in dichorionic twins discordant for congenital defect is a safe procedure with low risk of unintended fetal loss. This option is a reasonable alternative to expectant management or termination of the whole pregnancy.

Objective Children with Down syndrome (DS) can have hypoplastic thymuses with an impaired capacity to liberate newly generated T cells. We sought to determine if the size of the thymus in DS fetuses is different from control fetuses. Methods We performed comprehensive prenatal sonographic evaluation that included measurements of the thymus in 874 control fetuses and in 12 DS fetuses. We used graphic comparisons between thymic measurements obtained from the two groups of fetuses and a nested case-control validation study in which DS fetuses were matched for gestational age with control fetuses using a 2-to-1 ratio to make group comparisons. Results The plot analysis showed that more than two-thirds of DS fetuses had sonographic signs of thymic hypoplasia. The nested case-control study confirmed that the thymus of DS fetuses was statistically smaller than the thymus of control fetuses [DS transverse diameter 12.3 mm, interquartile range (IQR) 6.2 vs control 18.1 mm, IQR 4.4; p < 0.001 and, DS perimeter 30.9 mm, IQR 20.1 vs control 48.6 mm, IQR 20.4; p < 0.01]. Conclusions Our findings suggest that the majority of DS fetuses have smaller thymuses than control. Prenatal measurements of the thymus may be clinically useful in the management of DS pregnancies. Copyright © 2011 John Wiley & Sons, Ltd.

Resumen Introduccion la incidencia de las alteraciones del desarrollo de las estructuras osteocartilaginosas fetales es baja. Aunque su diagnostico ecografico es sencillo, especialmente en las osteocondrodisplasias letales, llegar a un diagnostico etiologico es complicado. El objetivo del presente trabajo es presentar los hallazgos ecograficos y resultados perinatales de las malformaciones esqueleticas diagnosticadas en nuestro centro. Material y metodos estudio descriptivo retrospectivo de serie de casos. Se incluyeron las malformaciones esqueleticas diagnosticadas prenatalmente en la Seccion de Medicina Fetal del Hospital General Universitario Gregorio Maranon (noviembre de 2004-febrero de 2010). Los casos se clasificaron en defectos del esqueleto axial o radial, tanto focales aislados como cuadros generalizados de displasias oseas. Se analizaron la edad gestacional al diagnostico, los defectos congenitos asociados y los resultados perinatales. Resultados durante el periodo de estudio se registraron 56 casos. La edad gestacional media al diagnostico fue de 23,7 semanas (rango 12-37; desviacion estandar 7,25). Veintiseis (46,4%) se presentaron como malformacion aislada; 14 (25%) asociadas a otras malformaciones, y 16 (28,6%) en el contexto de un sindrome polimalformativo. De los 29 (51,8%) casos en que se realizo estudio citogenetico, en 10 (34,5%) se diagnostico una cromosomopatia. En 40 casos (71,4%) el diagnostico fue de anomalia focal del esqueleto radial; en 5 (8,9%), de anomalia del esqueleto axial, y en 14 (25%), de osteocondrodisplasia. Solo en 11 casos se establecio un diagnostico nosologico. La supervivencia en el periodo neonatal fue del 61,1% (33/54). Conclusiones las malformaciones esqueleticas se asocian frecuentemente a otros defectos congenitos, de dificil diagnostico etiologico y con una alta tasa de resultado perinatal adverso.

The determination of reliable molecular-weight distributions of complex asphaltene fractions has challenged modern mass spectrometry. This investigation extends previous studies on the application in this field of one-step laser desorption/ionization (LDI) and two-step laser desorption/post-ionization (L2MS) techniques employing ultraviolet (UV) and mid-infrared (IR) wavelengths. In the LDI experiments, single-resonant UV (280 nm) or IR (3.45 μm) laser pulses are applied for desorption−ionization of a model asphaltene sample. In the L2MS approach, asphaltene neutrals are postionized in the gas phase by a high power UV (266 nm) laser pulse. The study confirms that one-step UV−LDI easily induces aggregation of the asphaltenes. In contrast, in one-step IR−LDI and two-step UV/UV−L2MS and IR/UV−L2MS, aggregation is largely suppressed and the measurements reproduce correctly the known molecular-weight distribution of the model asphaltenes, with a bulk of constituents within m/z 200−1000. It is shown that the tw...

The laser desorption/ionization (LDI) assisted by gold nanospheres, nanorods and nanostars has been investigated. Laser fluence thresholds for the appearance of cationized adducts of a polydispersed polyether standard (polyethylenglycol PEG600) have been determined at the near ultraviolet–visible–near infrared wavelengths delivered by a Nd:YAG laser (266, 355, 532, 1,064 nm). The results demonstrate the efficiency of surface plasmon excitation to assist laser desorption/ionizaton at laser wavelengths extending to the visible and near infrared, with advantages with respect to conventional LDI techniques using ultraviolet wavelengths. A close correlation is found between the optical absorbance of the nanoparticles and the LDI thresholds, although for the nanospheres plasmonic excitation in the visible appears to be more efficient than non-plasmonic excitation at shorter UV wavelengths. The recorded molecular weight distributions for the PEG600 standard show that the LDI process tends to be less efficient for the heavier components of the polymer mixture, presumably as a consequence of their stronger bonding to the nanoparticle substrate. The role of the coating agent of the nanoparticles in the observed LDI behavior is discussed.

A prenatal aortopulmonary window with an interrupted aortic arch was detected in a 22-week-old fetus. The 3-vessel and trachea view showed a communication between the ascending aorta and the pulmonary artery. Early postnatal surgery was successful. A PubMed-based search identified all cases of prenatal aortopulmonary windows between 2002 and 2015. Nine articles were identified. The average gestational age at diagnosis was 28 weeks (range, 22-33 weeks). The most frequent aortopulmonary window was type I (40%). All cases were associated with congenital heart defects, mainly an interrupted aortic arch (50%). No chromosomal or extracardiac abnormalities were seen. Prenatal echocardiography is useful for early diagnosis of an aortopulmonary window. The prognosis depends on the time of surgery and the nature of the associated anomalies.

Potocki-Lupski syndrome (PTLS) is a rare genetic disorder associated with neurodevelopmental delay and heart defects. We report the first case of prenatal diagnosis of PTLS in a fetus with hypoplastic left heart and aberrant right subclavian artery. Detection of a fetal heart defect should be followed by chromosomal and genetic studies in order to rule out fetal aneuploidy and/or associated genetic syndromes with significant implications for the treatment of children with PTLS.

Purpose: To compare axial view images obtained with fetal ultrasound (US) and magnetic resonance imaging (MRI) when applying the Cardiovascular System Sonographic Evaluation Algorithm (CASSEAL). Materials and method: CASSEAL is an US algorithm consisting on the acquisition of 9 different axial views of the fetal abdomen and chest, from the umbilical vein to the subclavian arteries. It was designed for a thorough US assessment of the extended fetal cardiovascular system. Feasibility and reproducibility of CASSEAL have already been proven; however, its application in fetal MRI has yet to be established. A fetal MRI was performed to a 25 week-old fetus with ventriculomegaly (11 mm) in order to obtain the 9 axial views required by CASSEAL. Subsequently, a comparison between both imaging techniques was performed for each view. Results: The comparison of the images obtained with these two imaging techniques showed a good correlation in the identification of cardiovascular anatomical structures. Conclusion: CASSEAL US axial views can be obtained in fetal MRI and correlation between the 2 techniques is good. This finding suggests that MRI may be a useful complement to US in the assessment of fetal cardiovascular anomalies using the same views by which sonographers assess fetal cardiovascular structures.

PURPOSE To compare measurements of the fetal thymus obtained by magnetic resonance imaging (MRI) and ultrasound (US). MATERIALS AND METHODS Written informed consent was obtained from the patients that participated in this Institutional Review Board-approved observational study. The study population consisted of 17 pregnant women carrying fetuses between 21 and 34 weeks of gestation with suspected abnormalities. The transverse diameter and perimeter of the thymus were measured in these fetuses at the level of an axial view of the thorax that includes the pulmonary, aorta, and superior vena cava. The degree of agreement between MRI and US measurements was determined using Lin's concordance correlation coefficient and Bland-Altman analysis. RESULTS The mean (standard deviation, SD) gestational age at the time of the prenatal evaluation was 28.4 weeks (3.6). The thymus was measured by MRI and US in all cases. Comparison of the measurements from these two imaging modalities demonstrated a relatively good reproducibility with no evidence of systematic error. CONCLUSION MRI and US measurements of the fetal thymus during the second half of pregnancy are comparable. This finding suggests that MRI can become a useful adjuvant to US for assessment of the fetal thymus.

Objectives The main objective of this study was to determine whether fetal thymic measurements could be obtained in twins, with a secondary goal to determine whether thymic measurements from uncomplicated singleton and twin pregnancies are comparable. Methods The transverse diameter and perimeter of the fetal thymus were measured prospectively in 678 singleton and 56 twin pregnancies, and their relationships with gestational age were determined and compared between groups. Results Thymic measurements were possible in 757 (95.8%) of the 790 fetuses. Measurements were not possible in 19 of 678 singletons (2.8%) and in 14 of the 112 (12.5%) twins (P < 0.001). After construction of nomograms for the transverse diameter and perimeter of the fetal thymus, similar measurements were noted for singletons and twins. Conclusions These results suggest that sonographic measurements of the thymus are feasible in twin pregnancies and that, in uncomplicated pregnancies, these measurements are similar to those noted for singletons. These findings pave the way for future studies aimed at determining the clinical utility of thymic measurements in complicated singleton and twin pregnancies. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

Objective. The purpose of this study was to determine whether the size of the thymus is different in male and female fetuses. Methods. In this prospective study, the transverse diameter and perimeter of the thymus were measured in healthy fetuses between 24 and 37 weeks' gestation. The means of the study variables from male and female fetuses were compared by the Student t test, and the relationships between the transverse diameter and perimeter of the thymus and gestational age and other common fetal biometric parameters were determined by linear regression modeling. Results. No differences were noted between male and female fetuses for the means of the study variables. After the relationship between the transverse diameter and perimeter of the thymus and gestational age was confirmed (R 2 = 0.8 and 0.75, respectively; both P

A new nanostructure based on TiO2, activated carbon and silver nanoparticles is synthesized in this work. The optical and morphological characterization of the nanoparticles is performed with well-established physicochemical-techniques. The photocatalytic properties of TiO2 are improved with activated carbon and extended to visible radiation with a silver nanoparticles doping. The synergy of the three materials to enhance biocide activity is successfully demonstrated in vitro in cultures of bacteria and algae and in aquatic controlled environments. This activity is supposed to be due to the augmentation in the superoxide and hydroxyl radicals in the presence of activated charcoal.

Objectives: Our aim is to describe the ultrasound findings, maternal and perinatal variables in cases with a prenatal diagnosis of persistence of right umbilical vein. Methods: A retrospective analysis of fetuses with ultrasound prenatal diagnosis of PRUV attending in two terciary centers, in Madrid. We describe clinical maternal-perinatal and fetal variables in all cases. Results: A total of 20426 deliveries were attending in both centers during the period of recruitment. Twenty-two cases (0.1%), with PRUV were detected. All cases were intrahepatic type a Ductus venosus with a normal Doppler waveform was presented in all cases. Nine fetuses (40.9%) were proved to have additional ultrasound anomalies. None of these non-isolated cases had chromosomal abnormalities. Cardiovascular malformations were the most frequently associated congenital anomalies. Conclusions: Based on our results and a literature review, PRUV has a potential association with other fetal malformations and a very low rate of chromosomal abnormalities. After prenatal diagnosis of persistent right umbilical vein a detailed anatomical evaluation and an echocardiography should be performed in order to rule out other structural malformations. Indication for fetal karyotype study has to be individualized considering persistence right umbilical vein type and other ultrasound findings.

A series of 25 fetuses in which ARSA was diagnosedusing transverse views was found in a group of pregnant women(between 16–36 weeks of pregnancy) attending our Fetal MedicineUnit for ultrasound examination (Figure 1A). After its detection ina transverse view, fetal ARSA was visualized in the coronal view bysweeping the probe at the level of the fetal thorax in a coronal planeanterior to the spine (Figure 1B). In this plane we were able to seethe thoracic descending aorta and the origin of the aberrant vesselin a distal position. Color and Pulsed Doppler was used to definethe course of the ARSA and distinguish it from other vessels.

at mean 34+1 weeks lead to emergency CS. One of these fetuses was growth-retarded (−36%) and was delivered at 29+5 weeks and had a subsequent normal development. Spontaneous onset of labor started in 17% at mean 34+6 weeks. Closing or closed gastroschisis was correctly diagnosed prenatally in 10%. In 2 of these cases, closed gastroschisis with subsequent short bowel syndrome occurred already before viability; the other cases could be delivered prior to irreversible bowel damage. Conclusions: The intense surveillance of fetuses with gastroschisis seems to be important for detecting cases at risk for fetal distress and may thereby reduce the risk of intrauterine fetal death. Especially in complicated cases, for example growth retardation, the CTG surveillance may be of utter importance. In addition correct diagnosis of closing/closed gastroschisis is possible and may prevent the risk of vanishing bowel.