Gastroschisis and omphalocele.

Infants with omphalocele and gastroschisis represent a challenging group of patients. Antenatal diagnosis may affect management by stimulating a search for associated anomalies, and by changing the site, mode, or timing of delivery. During the neonatal period, great care must be taken to minimize fluid and heat loss, and to prevent bowel distension. Although the goal of the surgeon is to accomplish abdominal wall closure in a single stage, a number of options exist where this is not possible. Other considerations include prevention and control of sepsis, nutritional support, respiratory status, and dysfunction of the liver, kidneys, and intestine because of increased abdominal pressure. Long-term outcome, in the absence of major chromosomal and structural anomalies, is excellent.