Fetal abdominal wall defects.

Abdominal wall defects are frequently detected prenatally. Optimal management requires identification of the type of lesion and a careful search for associated chromosomal and structural anomalies. For cases with lethal associated abnormalities, elective termination may be offered. Preterm delivery should be considered for fetuses with gastroschisis who have evidence of ongoing intestinal damage, as evidenced by bowel dilatation and thickening, although objective selection criteria are still being developed. There is currently no convincing evidence to support routine cesarean delivery in fetuses with abdominal wall defects. Most infants with abdominal wall defects should be born at a perinatal center, where neonatal and surgical expertise is immediately available. In every case, prenatal diagnosis should lead to parental counseling and decision-making by a multidisciplinary team consisting of obstetricians, neonatologists, and pediatric surgeons.