What Is Gastroschisis? Risk Factors, Symptoms And Treatment

Gastroschisis is a congenital defect in the abdominal wall of baby. The condition is characterized by an abnormal opening in the abdominal wall with protrusion of abdominal organs mainly intestine, stomach and liver. The hole is located invariably on the right side of umbilicus. The organs of abdomen such as intestine, stomach and liver push out from this hole into the amniotic sac when the baby is in the womb. Further development of the bowel takes place in the amniotic sac outside the fetal abdomen. The size of hole near umbilicus is generally 1 to 2 inch.

Since the intestine lies outside the body of fetus, it remains unprotected and it is prone to get damaged and inflamed. The condition is rare and occurs in nearly 1 out of 2000 live births. Gastroschisis develops usually between 4th and 8th weeks of pregnancy. The exact etiology is not known. But weakness in the muscles of abdominal wall adjacent to umbilical cord in the fetus seems to be the reason. Gastroschisis is detected on routine antenatal ultrasound scan. Usually delivery occurs at full term. After birth the defect can be repaired with surgery.

Causes And Risk Factors Of Gastroschisis

The exact cause of gastroschisis continues to elude researchers even though its prevalence in recent times has increased all over the world. The main underlying reason is weakness in the abdominal wall of the fetus, invariably on the right side of umbilical ring.

Several risk factors have been identified with development of this defect. This includes:

  • Young maternal age. It is more seen in pregnant woman below the age of 20.
  • Woman with low BMI during pregnancy.
  • Hispanic race.
  • Smoking during pregnancy.
  • Use of oral contraceptives and NSAIDs during pregnancy.
  • Drinking alcohol and consuming illicit or recreational drugs during pregnancy.
  • Low socio economic status.
  • There is no hereditary link associated with this condition.
  • Sampling of chorionic villi.

Symptoms Of Gastroschisis

The pregnant woman will not experience any symptoms of gastroschisis that occurs in the fetus. Gastroschisis is protrusion of the content of the abdominal cavity of fetus. It mainly includes the intestine. A small hole forms near the right side of fetal umbilical ring. Internal pressure in the abdomen of fetus causes protrusion of the intestine from the hole. Sometimes stomach of a part of liver may also project out. This may be visualized on sonogram when the fetus is in womb.

Gastroschisis is described into two varieties. Simple variety consists of protrusion of only bowels. In complicated type the bowel gets damaged and inflamed. There may be torsion or malrotation of the bowel which may lead to death the involved part of the intestine. In some cases there is incomplete formation of intestine or there is intestinal blockage. After birth baby may have feeding problem and poor bowel function if the condition is not corrected. Most infants have low birth weight.

Treatment For Gastroschisis

Gastroschisis cannot be treated when the baby is in mother’s womb. The condition can treated after birth of the baby. Any baby suffering from gastroschisis requires surgical repair. The baby cannot live with his organs of abdomen outside his body after delivery. During the surgery, the abdominal wall is stretched and the intestine is placed inside the abdomen. The hole that is present in the abdominal muscle wall is stitched.

Often surgery can be delayed due to inflammation of the intestine. In such case the intestine are covered properly with a special pouch. Once the inflammation is reduced it can be placed in the abdomen. After insertion into the abdomen, the intestine takes several days or weeks to function well. The neonate during this period is fed intravenously. Most neonates recover fully after surgery but few may require special formula food.