Prenatally diagnosed gastroschisis in monozygotic twins

✍ Scribed by David P. Gorczyca; Karen K. Lindfors; Kenneth A. Giles; John P. McGahan; Frederick W. Hanson; Frances P. Tennant

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 223 KB
• Volume: 17
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870170312

✦ Synopsis

Gastroschisis, a congenital defect consisting of a paraumbilical full-thickness defect in the anterior abdominal wall through which abdominal contents have herniated, has an incidence of 1 in 12,000 live births.' Prenatal detection of gastroschisis has been increased by current maternal serum alpha fetoprotein (MSAFP) screening programs since the defect is associated with an elevation in MSAFP.2-4 Since gastroschisis is only one of many conditions that elevates MSAFP, sonography is used to differentiate it from the other conditions that can cause similar serum abnormalities.

The etiology of gastroschisis is unknown, although several hypotheses have been sugg e ~t e d . ~-~ Most authorities doubt a hereditary or genetic however, there are sporadic reports in the literature of familial recurrence of the defect as well as one reported case of dizygotic twins with gastroschisis. We report the first case of monozygotic twins, each with gastroschisis. This diagnosis was established prenatally by MSAFP elevation and subsequent sonographic examination.

CASE REPORT

An 18-year-old primigravida woman, a participant in the California MSAFP Screening Program, was referred to our institution for evaluation of an elevated MSAFP. The MSAFP measured 8.5 multiples of the mean (MOM). An elevated MSAFP level for a single fetus is defined as one that exceeds 2.5 MOM and for twins is defined as one that exceeds 4.5 MOM for men-

From the Departments of