Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
195 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Baby has ventral abdominal wall defect. Karyotyping negative for abnormalities. How to go forward?

Answered by
Dr.
Dr. Monika Choudhary

OBGYN

Practicing since :2004

Answered : 816 Questions

default
Posted on Tue, 11 Sep 2012 in Women's Health
Question: Hi doctor,

My wife was diagnosed with the baby having ventral abdominal wall defect(gastroshisis) with single pulmonary artery and other cardiac problems doubted. this was detected during 14th week of pregnancy. She was given HCG 5000 units injection even week from 5th to 12th week, along with Susten 200 mg and folic acid tabs. doctor suggested us to go for MTP and so we did. they suspected chromosomal abnormality and hence the baby was sent for karyotyping. but the report says there is no such abnormalities. my wife is RH negative and hence, they gave anti-d injection, after the MTP. last year also, she had a spontaneous abortion at 7 weeks, D&C done and anti-d given at that time also. we are really worried now. please guide us how to go forward?
doctor
Answered by Dr. Monika Choudhary 1 hour later
Hi,
Thanks for posting your query.
Ventral abdominal wall defect with single pulmonary artery indicates towards chromosomal anomaly. More than 50% abortions in first trimester are also due to chromosomal anomaly.
But as you already said, karyotyping was negative. Now main thing is that your wife should undergo a TORCH(Toxoplasmosis,Rubella,Cytomegalovirus,Herpes)test.
Try for conception after a gap of at least 6 months & continue folvite tablets.
Hope for the best.
I will be available for your follow up queries if you have any.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Monika Choudhary 15 minutes later
Dear Dr. XXXXXXX Ji,

Thanks a lot for the immediate reply. TORCH test was already done and it was negative. we shall continue foliate tablets.

I have another query. I read on the net that excess of HCG intake speeds up the organ development, while abdominal wall closing happening at a slower rate, leading to abdominal wall defect. it is So? is there any study carried out in this regard?
the 6th week scan showed a slightly irregular gestational sac. is the shape of gestational sac indicate any anomaly? please explain.

CMR
doctor
Answered by Dr. Monika Choudhary 2 hours later
Hi,

Thanks for writing back.

Dose of HCG given to your wife was within normal range as prescribed by most of the gynecologist.

Side effects of excess dose of HCG are there like-
Multiple gestations,
Edema due to water retention,
Ovarian hyper-stimulation syndrome.

However, side effect like abdominal wall defect is not proven until now.

Gastroschisis is basically genetic disorder & you should take care in next pregnancy.

To rule out genetic disorder, you would have to carry out chorionic villous sampling at 9-10 weeks or amniocentesis at 16-18 weeks in next pregnancy.

If shape of gestation sac is irregular, it means growth is not proper.

For proper growth, sac should be regular, fetal node should appear at5-6 weeks & cardiac activity at 6-7weeks.

I think your query has been answered. Do let me know if you have more concerns.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Monika Choudhary 21 hours later
Dear Dr. XXXXXXX

Thanks a zillion for a detailed answer.

Please guide us how to go forward and plan for the next pregnancy?

what supplements / vitamins or hormones you suggest for Her?.

thanks in advance.

CMR
doctor
Answered by Dr. Monika Choudhary 5 hours later
Hi,
Welcome back.
There should be a minimum gap of six months between next conception.
There is no need of any extra hormone intake except folvite tblets.
Consult your gynaecologist regularly during next conception & follow all protocol like-
USG scan at 5-6 weeks,
Level 1 scan at 11 weeks,
Amniocentesis at 16-18 weeks,
Anomaly scan at 18-20 weeks.
I hope your query has been solved.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,  
Drug/Medication ,  
Medical Procedures ,  
Medical Topics

Recent questions on  Gastroschisis

doctor1 MD

my baby has gastroschisis and repaired when she was 3 days old. she was bon 2.12 kilos and now she is almost 8 kilos . sometimes she has problem...

doctor1 MD

My son is 5 years old. He was born with gastroschisis, do to many surgeries he now has short bowel syndrome. He was TPN dependent as an infant in...

doctor1 MD

my daughter was born with gastroschisis and now is 6 years old and now has a short gut. we have been denied social security disability 2 times. As...

doctor1 MD

my 14 year old daughter was born with gastroschisis and corrected with surgery. No problems until this past year. After periods of severe stomach...

doctor1 MD

Hi, I recently moved to a new place and the landlord refinished the hardwood floor about 3 weeks before we moved in. There is still smell there, I...

doctor1 MD

Hi, I took a TTT test when I was almost 13weeks pregnant and am not satisfied with either the quality of service in hospital or the results. am...