Successful management of gastroschisis - case report and literature review.

Background and objectives. Gastroschisis is a low-prevalence fetal anomaly with an excellent long-term prognosis and survival rates if early and adequate management is performed. It can be easily identified both prenatally and postnatally. It is described depending on the location of the defect, most often to the right side of a normally inserted umbilical cord. Prenatal ultrasound scans proved to be fundamental for the early diagnosis and for the prediction of likelihood complications, such as bowel atresia. Case report. We hereby present a fetus with gastroschisis who was diagnosed in the second trimester of pregnancy. After delivery, the newborn received proper surgical care and had a favorable outcome. At 4 years old, the baby had regular follow-ups as an outpatient, receiving full enteral nutrition. No hepatic damage was detected. We underline that there have been significant improvements in the outcome of newborns diagnosed with gastroschisis in the last 30 years, due to the in utero detection of this anomaly and to standardized neonatal care. Materials and method. We performed a systematic review of the available literature from 2013 to 2023 using PubMed and Google Scholar databases to search for published studies regarding ultrasound diagnosis and surgical management of gastroschisis according to PRISMA guidelines. The following search terms were used: "gastroschisis", "ultrasound", "neonatal surgery". Results. After the appropriate screening, we selected 15 papers. The diagnosis was first reached in one case in the first trimester, in seven cases during the second trimester and, respectively, two cases in the third trimester. In one case, the ultrasound showed normal previous scans, and for four cases, there were no available data for the gestational age at diagnosis. Surgery was performed on the first day of life for 11 neonates, and on the third, fourth, eighth and thirty-eighth days for the others. Conclusions. Multidisciplinary teams, including maternal-fetal medicine specialists, neonatologists and pediatric surgeons, are highly advised. This assures the best prenatal counseling and postnatal care. [ABSTRACT FROM AUTHOR]