<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 19-year-old woman, gravida 1, para 0, at 21 weeks gestation comes to the physician for a follow-up prenatal visit. At her previous appointment, her serum α-fetoprotein concentration was elevated. She had smoked 1 pack of cigarettes daily for 3 years but quit at 6 weeks gestation. Examination shows a uterus consistent in size with a 21-week gestation. Ultrasonography shows fetal viscera suspended freely into the amniotic cavity. Which of the following is the most likely diagnosis?? A: Diaphragmatic hernia, B: Umbilical hernia, C: Vesicourachal diverticulum, D: Gastroschisis, E: Omphalocele,  <response>: This is a medical question asking about the most likely diagnosis in a 19-year-old pregnant woman with an elevated serum α-fetoprotein level and ultrasound findings showing fetal viscera freely suspended in the amniotic cavity. The key findings are:- 19 years old, 21 weeks pregnant- History of smoking 1 pack per day for 3 years, quit at 6 weeks gestation - Elevated maternal serum α-fetoprotein level- Ultrasound shows fetal viscera freely floating in amniotic cavityThe differential diagnosis includes:A Diaphragmatic hernia - defect in diaphragm allows abdominal organs to herniate into chest cavity. Less likely with free floating viscera. B Umbilical hernia - protrusion of abdominal contents through abdominal wall near umbilicus. Would not cause free floating viscera.C Vesicourachal diverticulum - congenital defect resulting in herniation of bladder mucosa through umbilicus. Does not explain ultrasound findings. D Gastroschisis - full thickness defect in abdominal wall, usually to right of umbilicus, allows abdominal viscera to herniate freely. Most consistent with ultrasound findings.E Omphalocele - midline defect allows abdominal contents to herniate into umbilical cord. Herniated viscera contained in peritoneal sac, less likely to float freely.D: Gastroschisis 