Gastroschisis is a rare birth defect involving the digestive tract. The Cincinnati Children's Hospital estimates that one baby out of every 5,000 is born with the disorder. A normal baby is born with his stomach and intestines completely contained inside his body. A child with gastroschisis has a hole in the abdominal wall that allows these organs to extend outside the body. The stomach and intestines that poke outside the body can cause problems at both the feeding and elimination ends of the digestive process.
Diagnosis
Gastroschisis is usually diagnosed during pregnancy. Sometimes, the disorder goes unnoticed and is not diagnosed until birth. Routine prenatal ultrasounds can in some cases pick up the deformity as early as 14 weeks of gestation. The AFP test, another type of prenatal screening, may show higher-than-normal levels that can indicate a fetal abnormality of some kind. High AFP results are followed by more detailed ultrasounds that may reveal gastroschisis as the problem.
Symptoms
A baby with gastroschisis, considered to be a kind of hernia, will have a visible lump in her stomach. Loops of intestine are clearly seen outside of the body, next to the umbilical cord. The intestinal looping may hamper the movement of the baby in utero. Nutrients may not be delivered to the baby in a normal fashion due to the disorder.
Treatment
Treatment for gastroschisis takes the form of surgery. As soon as a baby is healthy enough to withstand surgery, the herniated section of the bowel is inserted into the body. Often, the procedure can be done within the first day of life. According to the Cincinnati Children's Hospital, approximately 66 percent of babies born with gastroschisis can be treated with a single surgery. Babies who are not stable enough to undergo the full procedure may need to have several staged operations to correct the deformity.
Long-Term Effects
The majority of infants who have a herniated stomach and intestine corrected show no adverse effects in the long term. Some children may experience a condition called short gut syndrome as a result of the gastroschisis. Short gut syndrome describes the lack of absorption of nutrients and diarrhea that children may experience due to the abnormal positioning of the intestine during prenatal development. Intravenous nutrition may be used to supplement meals if the child is not getting enough vitamins and minerals.
Considerations
Women who have received a prenatal diagnosis of gastroschisis for their babies need to devise a careful plan for delivery. Surgery will most likely be performed in the first few days of the baby's life, requiring a stay in a neonatal intensive care unit (NICU). Arrangements should be made to deliver at a hospital with sufficient equipment and expertise to treat the gastroschisis; transferring a sick newborn to a larger hospital puts added stress on both the baby and the parents, and should be avoided if possible. Obstetricians may choose to schedule a C-section once the unborn baby has reached full term at 37 weeks.
