Which of the following statements regarding gastroschisis are true?

c. Overall survival is approximately 80% to 90%

Gastroschisis is a full-thickness defect of the abdominal wall with herniation of a variable amount of uncovered intestine. Prenatal diagnosis has enabled the diagnosis of gastroschisis to be made prior to delivery. Prospective evaluation comparing vaginal delivery with elective cesarean section has demonstrated no difference in outcome. Therefore, careful vaginal delivery generally remains the birthing method of choice. Unlike omphalocele which is commonly associated (50%) with other anomalies, other structural anomalies are associated with gastroschisis in approximately 10% of patients.

Primary fascial closure after reduction of the herniated viscera is the best surgical option and this is possible in 60% to 70% of infants. Care must be taken not to generate excessive intraabdominal pressure when performing a primary abdominal wall closure. Generally, an intraabdominal pressure less than 20 cm H2O is well tolerated. If the herniated viscera cannot be reduced primarily, a silastic pouch constructed to temporarily contain the extra abdominal bowel and a series of partial reductions are begun. This approach combined with adequate nutritional support by total parenteral nutrition yields survival rates of at least 80% to 90% in most contemporary series of gastroschisis.