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WHAT YOU NEED TO KNOW:
What is gastroschisis?
Gastroschisis is a birth defect. Your baby's intestines, and sometimes other organs, are pushed through an opening near his belly button. The opening may be small or large. His intestines will float freely in amniotic fluid during pregnancy. This may cause the intestines to become irritated, swollen, or damaged. Your baby will be born with his intestines and any other involved organs outside of his body. Gastroschisis is a life-threatening emergency that needs surgery as soon as possible after your baby is born.
What increases my baby's risk for gastroschisis?
The exact cause of gastroschisis is not known. Your baby's risk may be increased if his mother used cigarettes, alcohol, decongestants, or NSAIDs during pregnancy. His risk may also be increased if his mother has urinary tract infections.
What do I need to know about delivery?
- Healthcare providers can usually see the intestines on an ultrasound before the baby is born. They will be visible on your baby's abdomen after he is born if it was not found on an ultrasound.
- You will need to deliver your baby at a hospital or facility that has experience with gastroschisis. Your baby may be premature or smaller than normal. He will need to stay in the neonatal intensive care unit (NICU) so he can be cared for by healthcare providers. He may be placed on his right side to keep the intestines from becoming twisted or developing other problems.
What will happen after my baby is born?
- A ventilator may be used to give your baby extra oxygen. A ventilator is a machine that breathes for your baby if he cannot breathe well on his own.
- A nasogastric tube may be used to relieve pressure. The tube will be placed into your baby's nose and guided down to his stomach. Suction is used to remove fluid and air from your baby's abdomen.
- Your baby will have an IV placed in a vein. Healthcare providers will use the IV to give him liquids and medicine. He will get nutrition through the IV so that his intestines do not have to process the nutrition. He will get antibiotics to prevent an infection caused by bacteria.
- Your baby will be kept warm. He will be placed in a warmer. The warmer will help prevent him from becoming too cold from his exposed organs.
- Your baby's intestines will be protected. Healthcare providers will wrap the intestines in moist gauze and cover them with plastic to prevent fluid loss from the intestines. They may place your baby's lower body in a medical bag. The bag is designed to keep your baby warm and prevent dehydration from moisture loss.
- Tests will be used to plan treatment. Healthcare providers may use x-ray, ultrasound, or other pictures to check your baby's organs. Blood tests will also be used to check for infection and show how well his organs are working.
How is gastroschisis treated?
Your baby may need to stay in the hospital for 1 to 3 months. He may need to stay longer if he has medical problems.
- Organ reduction means the amount of intestines is small enough for healthcare providers to put them back into place. They will be guided through the opening in your baby's abdomen. The opening may be covered with part of the umbilical cord stump. After a few days, the opening may close on its own. This method may give your child a more normal looking belly button when he is older.
- A silo is a device used to help put the organs back into your baby's abdomen. It is used if he cannot have surgery right away. Your baby's intestines are put into the silo. The silo is tightened over a few days to help guide the organs into place. The silo will then be removed, and the abdomen will be closed during surgery.
- Surgery is used to put your baby's intestines or other organs back into his abdomen. Your baby may have surgery right after he is born. He may need to wait a few days if he is not strong enough for surgery or if the opening on his abdomen is large.
What are the risks of gastroschisis?
- Your baby's intestines may become infected or develop necrosis (tissue death). He may have a shorter bowel than normal. This may prevent his body from absorbing nutrients correctly. He may need to have surgery on his bowel. As he grows, he may have trouble feeding or breathing. He may not grow as quickly as expected. He may also develop a bowel obstruction (block) or get sick more easily than other children.
- Even after the gastroschisis is repaired, your baby may have problems feeding. His body may not absorb nutrition correctly and he may need a feeding tube. Liquid from his stomach may get pushed into his lower esophagus and cause damage. He may have constipation or abdominal pain often. He may develop a food allergy or intolerance.
How can I prevent gastroschisis in a future pregnancy?
Take prenatal vitamins as directed. Make sure the vitamins contain 400 micrograms of folic acid. Folic acid helps prevent birth defects such as gastroschisis. Do not smoke cigarettes or drink alcohol while you are pregnant. Do not take any medicines unless your healthcare provider says it is okay. Ask your healthcare provider for other ways to prevent gastroschisis.
Call 911 if:
- Your baby is not breathing, has breathing problems, or is wheezing.
- Your baby's skin or nails are blue.
When should I seek immediate care?
- Your baby has a fever.
- Your baby has constipation, blood in his bowel movement, or loses weight.
- Your baby has apnea (periods of not breathing).
- Your baby has green or yellow vomit.
When should I contact my baby's healthcare provider?
- Your baby has fewer bowel movements than usual or has feeding problems.
- Your baby has a swollen abdomen or is vomiting.
- Your baby is crying more than usual, fussy, or difficult to comfort.
- You have questions or concerns about your baby's condition or care.
Care AgreementYou have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
© 2018 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.