Centers for Disease Control
Gastroschisis is a birth defect in which the baby's intestines
(bowels) stick out through a hole to one side of the belly button.
One explanation for why gastroschisis happens is that the yolk sac does not become part of the the umbilical cord,
as it normally does,
leaving a hole about 2 to 4
centimeters (0.8 to 1.6 inches) wide that is nearly always to the
right side of the belly button. The opening allows the baby's
intestines to poke through to the outside of the baby's body and
float freely unprotected in the amniotic fluid. Sometimes the
bladder or the ovaries in girls and testes in boys will also
be found outside of the opening [1, 2]
How will Gastroschisis Affect My Baby?
Direct contact of the baby's
bowels with the amniotic fluid that surrounds the baby can cause
the baby's bowels to become irritated and function poorly. The bowel may
become damaged or fail to develop normally in some areas (atresia). Very
damaged bowel may need to be removed, and there may be too little normal
bowel left to take in enough nutrients from food (short bowel syndrome).
Some babies will not have enough bowel left to survive, or will die from
infection after delivery. Up to 20% of babies
may be expected to have some damage to their bowel at birth. However,
most children with repaired gastroschisis are able to live active and
productive lives The overall survival rate is about 90% [3-11].
What Causes Gastroschisis ?
We do not know what causes gastroschisis , but
gastroschisis is seen more often in the babies of
mothers who are less than 25 years old. There also seems to be an increased chance for having
a baby with gastroschisis if the mother is underweight, she has had
another pregnancy within the last 12 months, she has had genitourinary tract infection
in early pregnancy , or the pregnancy is with a new father [12-16].
Gastroschisis has also been linked to a
wide variety of exposures including use of methamphetamine
(and other similar drugs), ibuprofen, decongestants, cigarette smoking,
alcohol consumption, exposure to certain weed killers, X rays , and air
Gastroschisis occurs in about 1 in every 2,000
births, and for unclear reasons has been occurring more often over the
last few years [10, 26-28]. The risk of
recurrence amongst siblings is 3.5%. Most cases of gastroschisis occur
unpredictably, and gastroschisis likely results from an
interaction of many factors [29-31].
Evaluation [32, 33]
Gastroschisis can be seen during an ultrasound examination. About 1 in 10 babies with
gastroschisis may also have a heart abnormality or other birth defect.
Additional findings in some babies may go undetected until after delivery. If your baby has gastroschisis and another
finding is seen that suggests the baby may have a chromosomal abnormality, a test called an amniocentesis may be offered
to you to count and examine the chromosomes of the baby. Amniocentesis is a test
in which a fine needle is inserted into the uterus (womb) , and a sample of the
that surrounds the baby is removed to obtain the baby's cells that are present
the amniotic fluid.
Effect on Pregnancy [10, 34-37]
Gastroschisis usually causes the maternal serum alpha-fetoprotein (MSAFP)
screening test to be positive for a possible neural tube defect (a defect in
the baby's spine or skull).
Babies with gastroschisis are likely to grow more slowly than other babies
while in the womb .
Babies with gastroschisis are more likely to be born prematurely .
Babies with gastroschisis are more likely to have low amniotic fluid.
Babies with gastroschisis are more likely to be stillborn (to die in the
It is often helpful to meet with the
pediatric surgeon who can discuss details of any operations and
what you might expect for your baby.
Your baby will be measured using an ultrasound
machine every 3 to 4 weeks to make sure it is growing well.
During the ultrasound examination your doctor may also
look for abnormalities in blood flow through the umbilical cord,
increased size or activity of the bowel, or a change in the amount of
amniotic fluid that might indicate your baby should be seen more
Your baby's heart rate and movement will be monitored
two times per week or more using an electronic monitor starting at 28 to
32 weeks. This test is called the Non Stress Test (NST). The fluid
around the baby is measured at the same time of the nonstress test.
Delivery [45-52, 55]
Your baby should be delivered at a hospital with
pediatric surgery services and a neonatal intensive
care unit available. A neonatal intensive
care unit ,or NICU, is an area of a hospital dedicated to treating and
monitoring babies who are seriously ill. Infants
with gastroschisis appear to be safely delivered vaginally, and delivery by cesarean section has not been shown to consistently improve
the outcome of infants with gastroschisis.
There is no generally agreed upon way to manage
gastroschisis. The timing of delivery is usually based on several
factors including the age of the baby, growth of the baby, the amniotic
fluid level, fetal testing results , and the appearance of the bowel.
After Delivery [53,54]
At delivery the bowel is protected with moist sterile dressings, and the baby
is fed through an intravenous (IV) line. If possible a surgeon will put the
bowel back into the abdomen and close the hole in the baby's belly. if there
is not enough room for the bowel to fit into the abdomen, a plastic bag (a Silo) is
placed over the bowel, and the bowel is allowed to return to the abdominal
cavity with the aid of gravity. Once the bowel has returned to the abdomen,
the abdomen is closed surgically.
After the procedure, the baby is fed using a feeding tube until normal bowel
function occurs . Babies may spend 1 to 2 months or more in the
intensive care unit.
Gastroschisis Support Group, Australia
Gastroschisis Support, Resources, Videos and ...
Reviewed by Mark Curran, M.D. FACOG
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