Gastroschisis is a serious birth defect that occurs in 1 out of 2,000 newborns. Most babies with gastroschisis are diagnosed through prenatal ultrasound. Treatment in an experienced neonatal center with the necessary resources available is key to successful outcomes.
Gastroschisis is a birth defect that results in a hole in the abdominal (belly) wall near the umbilical cord. It may be diagnosed as early as 12 weeks by a prenatal ultrasound. The intestines are pushed out of the body through this opening and have their remaining growth through the pregnancy outside of the body - exposed to the amniotic fluid.
This causes the abdominal cavity to remain small and the intestines to develop changes which prevent them from functioning at the time of birth. In most babies, the intestines recover their function within a few weeks but in some cases, there may be permanent damage.
After diagnosis, you will meet with all specialties which are needed for your baby’s care. This meeting will include:
This team will discuss with you the monitoring needed during your pregnancy, the delivery plan and the care of your baby after delivery.
At the time of delivery, the neonatologist will make sure the transition to treating and vital signs are safe and your baby will be placed in a sterile bag up to the chest to cover the intestines and protect them from infection and injury.
The pediatric surgeon will assess the defect and decide if a silo is needed — a sterile, clear plastic tube that fits over the intestines and is inserted through the hole. This allows the intestines to be gradually pushed down into the abdomen over several days after which your baby will have a surgery to remove the silo and close the hole.
Most babies have a delay in intestine function that lasts 2-3 weeks after birth. During this time, they will need a special IV to allow full feedings of special nutrients. The doctors at Riley at IU Health encourage breast feeding and you will be given assistance with pumping to create a supply of milk which will be kept safe for your baby in our milk lab.
If damage to the intestines has occurred before delivery, some intestine may be missing and a longer hospital stay and additional surgeries may be needed.