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Gastroschisis 1

Gastroschisis
embryology

Question

Vignette: A 20-year-old woman presents to the clinic for a routine prenatal visit. She is currently 16 weeks pregnant. An ultrasound is performed, revealing a fetus with a defect in the anterior abdominal wall, causing the abdominal contents to be exposed outside of the body. Which of the following embryologic processes most likely failed to occur properly in this fetus?

Choices

A. Fusion of the neural tube

B. Rotation and fusion of the cardiac tubes

C. Closure of the ventral body wall

D. Separation of the cloaca

E. Formation and migration of neural crest cells

Answer

C. Closure of the ventral body wall

Explanation

The described ultrasound findings are consistent with gastroschisis, a congenital defect in which the anterior abdominal wall fails to close properly, leading to exposure of the abdominal contents outside of the body. This defect arises from an error in closure of the ventral body wall during embryologic development. The ventral body wall forms from lateral and cranial folding of the embryo, and its closure is usually complete by the end of the fourth week of gestation. Failure of this process can result in defects like gastroschisis. Note that gastroschisis is not associated with other congenital anomalies, and it differs from omphalocele, another anterior abdominal wall defect, in which the herniated organs are covered by a membrane.

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