Gastroschisis is a congenital disability where the abdominal wall does not fully develop while the baby is in the womb. It occurs in 1 in 2000 live births. The incidence of Gastroschisis is increasing worldwide.
We have compiled information on Gastroschisis complications and treatment to guide parents.
Gastroschisis is also called Laparoschisis. It is a birth defect that develops in a baby during early pregnancy. The condition affects the baby’s abdominal wall. Gastroschisis happens when the baby’s abdominal wall does not close properly. It forms a hole – in most cases towards the right of the baby’s belly button. This hole can be large or small. Gastroschisis causes the intestines to push through this hole and develop outside of the baby’s body in the amniotic fluid.
In more severe cases, other organs such as the stomach or the liver can sometimes make their way through the opening.
Because the intestines are outside of the baby’s body, it is unprotected, causing them to become irritated, swollen and damaged.
The exact cause of Gastroschisis is not entirely known. However, some identified Gastroschisis causes include:
There are no symptoms during pregnancy. At birth, the sign of Gastroschisis is a hole in the abdominal wall of the baby with the intestine protruding out near the umbilical cord.
Gastroschisis is diagnosed before birth at around 20 weeks of gestation during a prenatal ultrasound. It may also result in an abnormal result on a blood or serum screening test. Sometimes the doctor may ask for an MRI to get a better look at the abdomen of the baby.
It can also be seen immediately when the baby is born.
Left untreated, Gastroschisis is fatal to the child.
If Gastroschisis is found before birth, doctors will monitor the mother to ensure the health of the unborn baby. Mothers will need to give birth in a hospital with a Newborn Intensive Care Unit (NICU).
After the baby is born Gastroschisis treatment involves surgery. If the Gastroschisis defect is small, with only some part of the intestine outside of the belly, doctors treat it with surgery soon after birth. The surgery aims to put the organs back and close the opening.
If the defect is larger with many organs exposed, Gastroschisis treatment is done in stages. First, a mesh sack called a silo is stitched around the exposed organ. They are then slowly moved into the abdominal cavity, and the defect can then be closed.
During this period, the baby’s temperature must be monitored and controlled because the exposed intestine allows body heat to escape. This is because of the pressure of returning the intestines to the abdomen, the baby may need support to breathe with a ventilator.
After surgery, the vital signs, cardiovascular and respiratory status, fluid and electrolyte balance, and pain of the baby will be monitored and managed.
A urinary catheter may also be used along with 120 to 170 mL/kg/d of a crystalloid solution for adequate urine output.
An IV line will give nutrients and antibiotics to prevent infection. Even after the defect is closed, the doctor will continue the intravenous feeding as milk feedings must be introduced slowly.
In most cases, the condition is detected during a prenatal check using blood tests, ultrasounds and MRIs. This ensures you and your doctor have time to plan the birth and discuss the best way to manage the condition.
Babies with Gastroschisis may be born prematurely. They may also grow slowly in the womb, causing them to be smaller than usual. They rarely have other birth defects, chromosome abnormalities, or genetic conditions.
Other complications include:
Digestion: A baby with Gastroschisis may have scar tissue or an intestinal blockage that affects digestion. Some organs may get damaged when your baby’s provider squeezed them through the hole in the belly. Sometimes, children may develop problems with digestion later in life. In rare cases, babies with Gastroschisis have a missing part of the intestine, a thinner than usual part of the intestine, or have a twisted piece of the intestine.
Infections: One in three babies with Gastroschisis develop necrotizing enterocolitis (also called NEC). This happens when the tissue of the intestine dies. In some cases, a hole called an intestinal perforation might form in the intestine. This may cause waste and bacteria from the baby’s intestine to leak into the blood or the abdominal cavity.
Researchers sometimes link abnormal changes in genes or chromosomes to Gastroschisis. This is yet to be confirmed.
Gastroschisis has an excellent prognosis with a survival rate of around 90% to 95%.
The bottom line,
Gastroschisis is a birth defect that affects an unborn baby’s abdominal wall. Despite its complications, Gastroschisis can be successfully treated with no long-term health problems. Babies born with this condition tend to be smaller than average. However, with proper care and nutrition after surgery, these babies can catch up with other kids their age.
It has been suggested that folic acid can help prevent Gastroschisis. Hera’s prenatal vitamins provide essential nutrients along with Folic Acid for a healthy baby.