Gastroschisis is a medical condition where part of the abdominal wall is open and babies are born with intestines and sometimes other abdominal organs appearing on the outside of the body. While the condition may seem as though it would happen very rarely, the fact is about 1 in every 2000 births are affected by Gastroschisis.
When a baby presents with Gastroschisis, the intestines, stomach and sometimes part of the liver can be visible on the outside of the body. This happens because of a congenital defect in the abdominal skin and the peritoneal covering over the intestines which is thought to occur because part of the abdominal wall did not close correctly. The size of the actual hole will often be very small, but due to the fact that the Gastroschisis occurs in the beginning weeks of gestation, the organs often grow on the outside as opposed to the inside of the body.
Many parents are prepared for the occurrence of Gastroschisis as ultrasounds as early as 14 weeks show the defect in the abdominal wall and the formation of the intestines on the outside of the body. As soon as the baby is born, the intestines are covered with a sterile gauze or wrapping and the baby is eventually taken to surgery to repair the Gastroschisis.
Repairing Gastroschisis involves pushing the organs back into the abdominal cavity of the body and repairing the peritoneal defect, as well as closing the hole in the abdominal wall. The problems associated with Gastroschisis, however may not be solved solely by repairing the physical damage and closing the skin.
When the intestines are formed on the outside of the stomach cavity, they are in contact with the amniotic fluid for the duration of the gestational period. Intestinal contact with the amniotic fluid can cause serious flaws in the growth patterns of the intestine or a thickening of the intestine. The longer the intestine is in contact with the amniotic fluid, the worse the permanent damage may become. This is especially true after the 35th week of pregnancy.
Many obstetricians choose to plan a C-Section in cases where the Gastroschisis has been noted via ultrasound, though there is no clear proof it makes a significant difference in outcome. Cesarean sections are often done to time the surgical repair, assemble the surgical team and make the surgical team available for repairing the defect
During the surgical repair of the Gastroschisis, the doctors may have difficulty replacing the organs into the abdominal cavity. During gestation, the stomach cavity was formed without these organs in place. The results in a smaller than normal abdominal cavity. In some cases, the Gastroschisis will require several surgeries will be required in order to fit all of the organs back into the stomach cavity without strangulating the intestines.
After surgery, the NG tube used to keep the stomach and the bowel empty will remain in place until the baby exhibits full bowel function. The majority of the Gastroschisis cases are corrected with surgery without any further complications associated with the condition.