Gastroschisis, an abnormal opening in the abdominal wall that allows the intestines to extrude from the body, occurs in around 1 in 5,000 births, the Children's Hospital of Wisconsin (CHW) states. The opening usually occurs to the right of the umbilicus. Gastroschisis develops in babies whose mothers are young, almost never older than 30 years old, CHW reports, and often under age 20, according to the Children's Hospital of Philadelphia. Gastroschisis generally doesn't occur in conjunction with chromosomal abnormalities or other structural defects. While gastroschisis can usually be successfully repaired surgically, complications related to gastroschisis can occur both before and after birth.
Fetal Complications
Gastroschisis is usually diagnosed through ultrasound visualization of the intestines floating in the amniotic fluid after 12 weeks. Elevated alpha fetoprotein blood levels may occur but aren't specific to gastroschisis. Once gastroschisis is diagnosed, close monitoring of fetal growth and development helps prevents complications such as growth retardation, stillbirth, preterm labor and abnormally low amounts of amniotic fluid called oligohydramnios, according to the University of Michigan Health System. Approximately 75 percent of infants with gastroschisis are smaller than normal; the stillbirth rate is approximately 10 percent, CHW states.
Intestinal Complications
Floating in the amniotic fluid before birth damages the intestines in 20 to 40 percent of babies with gastroschisis. Intestines are often initially very dilated and swollen but shrink and fit back into the intestine gradually. Common intestinal tract complications of gastroschisis include volvulus (twisting of the bowel that can result in necrosis), malrotation (abnormal positioning of the intestines) and atresia (a blockage in the intestine), CHW reports. Blood supply to part of the intestine may be cut off, causing bowel death. Dead or necrotic bowel must be removed and the healthy ends reconnected in additional surgeries. If too much bowel is lost, short gut syndrome, where not enough bowel is left to absorb adequate nutrition, can occur.
Feeding Complications
Babies with gastroschisis often have feeding problems even after surgery. Babies are not fed until the intestines begin to work; signs of returning bowel function include bowel sounds heard through a stethoscope and passage of bowel movements. This can take several weeks, the University of Michigan Health System states. Initial feedings are done through a nasogastric tube and are increased very slowly so that the bowel isn't stressed and infection doesn't occur. Babies who need long term intravenous fluids because they can't tolerate regular feedings may develop liver damage.
