What Are the Treatments for Gastroschisis?

Gastroschisis occurs when a baby's intestines protrude though a hole in the abdomen next to the umbilical cord. This birth defect occurs in approximately 1,500 babies each year in the U.S., according to the Centers for Disease Control and Prevention. Treatment to place the intestines in the abdominal cavity begins at birth.

Diagnosis and Delivery

• A gastroschisis diagnosis is often made when a routine ultrasound during pregnancy reveals the problem. As your pregnancy progresses, you will need frequent ultrasounds to make sure that the baby is growing as expected. According to the Children's Hospital of Wisconsin, there is a higher incidence of stillbirth when a baby has gastroschisis. Your doctor may recommend that labor be induced between 35 to 37 weeks to reduce the chance of stillbirth. Babies with gastroschisis can be born during a vaginal delivery or through a Caesarean section. Once your baby is born, he will be admitted to the neonatal intensive care unit for treatment of the condition.

Silo Treatment

• After your baby is born, her lower body will be placed in a sterile bag to prevent infection in the exposed intestines. A silo, a special kind of sac, is wrapped around the intestines, holding them above the abdomen. Over the course of a week or more, the effects of gravity gently push most of the intestines into the abdominal cavity. When the intestines are level with the abdomen, surgery will be used to place the remainder of the intestines in the abdomen and close the opening. During silo treatment, your baby's temperature will be carefully monitored to ensure that too much body heat does not escape through the abdominal opening.

Surgery

• In some cases, a surgical procedure called a primary closure is used to replace the intestines is the abdomen shortly after birth. If the abdominal cavity is not large enough at the time to accommodate all of the intestines, a silo may be used after primary closure surgery. Another surgery will be required when the intestines can safely fit in the abdominal cavity. In other cases, the silo treatment may be used before primary closure surgery. If the intestines have been exposed to amniotic fluid, they may become inflamed and swollen. When this happens, the inflammation must be treated and the intestines cannot be immediately replaced in a primary closure.

Recovery

• When the intestines are replaced in the abdominal cavity, increased pressure may be placed on the diaphragm, the layer of muscle that separates the abdominal cavity from the lungs and chest cavity. A breathing tube may be needed for a few days until your baby has no problem breathing on his own. He will not be fed following surgery because it is important to keep the stomach empty to avoid placing additional pressure on the diaphragm. Instead, nutrients and fluids will be placed in a central intravenous line and a nasal gastric tube will inserted prior to surgery to keep the stomach empty. When your baby can start eating, he may initially have some difficulty learning how to feed from a bottle or breast.

Complications

• Narrowing of the bowel after gastroschisis surgery may occur in a small number of cases.Your doctor will be able to determine if this is a problem if there is a lack of bowel sounds, stool is not being passed spontaneously or drainage from the nasal gastric tube does not decrease after surgery. If these things happens, additional surgery will be needed to correct the narrowing and allow normal bowel function.