Fetal gastroschisis complicated by bowel dilation: an indication for imminent delivery?

Antenatal diagnosis of fetal gastroschisis permits study of bowel appearance throughout gestation. Fetal bowel dilation has been regarded as a 'high-risk' condition requiring imminent cesarean delivery. We report 2 cases of gastroschisis with onset of bowel dilation in the third trimester. At surgery, the bowel was patent. Neither fetus had evidence of acute bowel damage following expectant management and vaginal delivery. Both underwent a one-stage repair. We conclude that antenatal bowel dilation does not necessarily reflect bowel injury or a poorer neonatal prognosis. In our experience, bowel dilation in fetal gastroschisis does not represent a separate indication for cesarean delivery and can be associated with a good outcome following vaginal delivery.