Gastroschisis is a congenital defect that affects development of the abdominal wall while a baby is growing inside the womb. The baby is born without their abdominal wall intact and surgery is required shortly after birth to place the intestine inside the abdomen and close up the abdominal wall.
Characteristics and pathology
The abdominal wall develops early on in pregnancy. While the wall is developing, the intestine moves into the umbilical cord, only moving back inside the abdominal cavity once the abdominal wall is fully formed. In gastroschisis, this wall does not fully develop and the intestine continues to develop outside of the baby’s body. The baby is born with their intestine exposed to the open air and vulnerable to infection.
Causes of gastroschisis
The exact cause of gastroschisis is not clear. However, the condition is more common among younger mothers, aged under 20 years. Overall, the incidence of gastroschisis is low, with 1 in 3000 newborns affected every year.
This condition is easy to diagnose because the child is born with their intestine exposed. The intestine may be darker in areas that have been damaged by contact with amniotic fluid. The umbilical cord is visible but has usually been pushed aside by the mass of the intestine.
Diagnosis and treatment
Diagnosis can be made based on clinical appearance and examination. In many cases, the condition is detected during a prenatal check using ultrasound scanning, which allows time to plan the birth and discuss the best way to manage the condition.
Once the baby is born, the exposed bowel is immediately covered with a sterile material and the baby is administered fluids using a drip. A tube is used to drain away bile from the stomach and reduce the risk of vomiting during surgery. The baby is usually anesthetized within 24 hours of birth and an operation is performed to place the exposed intestine back inside the abdominal cavity and seal the hole in the abdominal wall.
Reviewed by Sally Robertson, BSc