|San Gabriel Valley Perinatal Medical Group|
Gastroschisis is a birth defect in which the baby's intestines (bowels) stick out through a hole to one side of the belly button. One explanation for why gastroschisis happens is that the yolk sac does not become part of the the umbilical cord, as it normally does, leaving a hole about 2 to 4 centimeters (0.8 to 1.6 inches) wide that is nearly always to the right side of the belly button. The opening allows the baby's intestines to poke through to the outside of the baby's body and float freely unprotected in the amniotic fluid. Sometimes the bladder or the ovaries in girls and testes in boys will also be found outside of the opening
How will Gastroschisis Affect My Baby?
Direct contact of the baby's bowels with the amniotic fluid that surrounds the baby can cause the baby's bowels to become irritated and function poorly. The bowel may become damaged or fail to develop normally in some areas (atresia). Very damaged bowel may need to be removed, and there may be too little normal bowel left to take in enough nutrients from food (short bowel syndrome). Some babies will not have enough bowel left to survive, or will die from infection after delivery. Up to 20% of babies may be expected to have some damage to their bowel at birth. However, most children with repaired gastroschisis are able to live active and productive lives The overall survival rate is about 90% .
What Causes Gastroschisis ?
Gastroschisis has also been linked to a wide variety of exposures including use of methamphetamine (and other similar drugs) ibuprofen, decongestants, cigarette smoking, alcohol consumption, exposure to certain weed killers, X rays , and air pollutants
Gastroschisis occurs in about 1 in every 2,000
births, and for unclear reasons has been occurring more often over the
last few years . The risk of recurrence
amongst siblings is 3.5%. Most cases of gastroschisis occur
unpredictably, and gastroschisis likely results from an
interaction of many factors.
Gastroschisis can be seen during an ultrasound examination. About 1 in 10 babies with gastroschisis may also have a heart abnormality or other birth defect. Additional findings in some babies may go undetected until after delivery. If your baby has gastroschisis and another finding is seen that suggests the baby may have a chromosomal abnormality, a test called an amniocentesis may be offered to you to count and examine the chromosomes of the baby. Amniocentesis is a test in which a fine needle is inserted into the uterus (womb) , and a sample of the amniotic fluid that surrounds the baby is removed to obtain the baby's cells that are present the amniotic fluid
Effect on Pregnancy
Your baby should be delivered at a hospital with
pediatric surgery services and a neonatal intensive
care unit available. A neonatal intensive
care unit ,or NICU, is an area of a hospital dedicated to treating and
monitoring babies who are seriously ill. Infants
with gastroschisis appear to be safely delivered vaginally, and delivery
by cesarean section has not been shown to consistently improve the
outcome of infants with gastroschisis. There is no generally agreed upon
way to manage gastroschisis. The timing of delivery is usually based on
several factors including the age of the baby, growth of the baby, the
amniotic fluid level, fetal testing results , and the appearance of the
At delivery the bowel is protected with moist sterile
dressings, and the baby is fed through an intravenous (IV) line. If possible a
surgeon will put the bowel back into the abdomen and close the hole in the
baby's belly. If there is not enough room for the bowel to fit into the
plastic bag (a Silo) is placed over the bowel, and the bowel is allowed to
return to the abdominal cavity with the aid of gravity. Once the bowel has
returned to the abdomen, the abdomen is closed surgically.