Gastroschisis In Newborns

Gastroschisis is one of the most frequent congenital malformations, but which in turn is unknown by the majority of the population. This malformation occurs when the muscles in the baby’s abdominal wall do not form properly in early pregnancy.

Thus, an orifice is formed in the child’s abdomen through which the intestines and other organs exit. It usually occurs on the right side of the navel. As the intestines are exposed to amniotic fluid, they can become irritated. For this reason, they may shrink, swell or twist.

Once the baby is born, surgery will be needed to place the organs inside the body and to repair the abdominal wall. However, despite the surgery, babies who suffer from gastroschisis can have problems with feeding, digestion and absorption of nutrients.

Causes and risk factors for gastroschisis

Some cases of gastroschisis are due to changes in genes, although in other cases they may be due to a combination of genetic factors and factors related to the mother during pregnancy. As for the factors that increase the risk of having a baby with gastroschisis, we can highlight:

• Being a mother at an early age: Teenage mothers are more likely to have a baby with gastroschisis than more mature mothers.
• Tobacco and alcohol consumption: Women who smoke and consume alcohol are at greater risk of having children with gastroschisis.

Diagnosis and treatment

Diagnosis may be before birth or as soon as the baby is born. During pregnancy, tests for malformation are performed, therefore, with specific exams, it is possible that the problem is detected. Also, it is seen on an ultrasound.

As for treatment, gastroschisis is a life-threatening condition. We need a urgent treatment as soon as the baby is born so that their organs are developed and are protected inside the abdomen.

In case the defect is small, it can be repaired in a single intervention. However, if it is a large defect, in which many organs have been exposed to the outside, the repair can be done in stages. After surgery, the baby goes to the newborn intensive care unit.

Surgery Risks

The risks of anesthesia and general surgery are:

• Allergic reactions to medications.
• Breathing problems.
• Infection and bleeding.

As for the risks involved in repairing gastroschisis, we can mention:

• Breathing problems: can appear if the baby’s abdominal space is smaller than normal. The newborn may need a breathing tube and a vacuum for a few days or weeks after surgery.
• Inflammation of the tissue lining the abdominal wall.
• Organ damage.
• Temporary paralysis of the small intestine.
• Abdominal wall hernia.

Complementary treatments

On the other hand, babies with this problem often also need other treatments, such as:

• Nutrition by nasogastric tube placed in the nose to feed and eliminate stomach contents.
• Liquids and nutrients through a vein.
• Oxygen.
• Antibiotics to prevent infections.
• Analgesics.

Feeding begins with a nasogastric tube as soon as the baby’s bowel function resumes after surgery. However, oral feeding will be done very slowly. Discharge is usually administered within 15 to 25 days of admission.

Prevention of gastroschisis

In these cases, ultrasound plays an important role. In fact, weekly ultrasound monitoring is recommended from 30 weeks of gestation onwards.

Generally, newborns with gastroschisis are underweight and between 10 and 20% have intestinal malformations. However, the degree of bowel disorder will largely determine the prognosis of these babies.

In recent years, survival has increased markedly. This is due to early detection and application of monitoring protocols as well as appropriate intensive care.