CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND UNDERSTANDING GASTROSCHISIS

GASTROSCHISIS OVERVIEW

Gastroschisis is a in which the abdominal wall does not close completely, allowing intestine (bowel) and other abdominal contents to slip through a small defect (opening) near the belly button, and stay outside the belly, while the baby grows.

Gastroschisis occurs 1-2 times per 10,000 births. It is not known what causes gastroschisis, but it is more common in younger mothers. Unlike other abdominal wall defects, such as , gastroschisis is rarely associated with chromosomal abnormalities or other structural abnormalities, except for (blockage).

DIAGNOSIS TREATMENT SURGERY AND FOLLOW- Gastroschisis is diagnosed by routine The treatment for gastroschisis is UP CARE ultrasound during the second trimester of surgery to place the bowel back The baby will continue to be cared for by pregnancy. in the and close the the and abdominal wall defect. There are teams in the NICU after surgery. The baby PREGNANCY AND DELIVERY di erent ways to surgically repair will most likely feed via special intravenous gastroschisis, based on how much (IV) nutrition until the bowel starts to work After your initial ultrasound, you will be referred of the abdominal contents are properly after surgery, which can take up by your obstetrician or perinatologist to the outside of the abdomen, and if to four weeks. The intravenous nutrition pediatric surgeon, neonatologist, and nurse there are any complications with will supply your baby with all nutritional coordinator for consultation. The team will then the intestine. requirements until he/she is able to develop a care plan for your baby at delivery tolerate food by mouth or via a gastric Primary Repair: If the surgeon and thereafter. tube. We wait to give the baby breast milk feels that the intestines can be or formula until the bowels begin to work. placed back into the abdomen You will continue to have ultrasounds Signs that the bowels are working include without too much pressure on the throughout your pregnancy to follow your bowel sounds, spontaneous passage of bowel they will close the abdomen. baby’s growth and amniotic fl uid volume. stool, and a decrease in the amount of drainage coming from the tube in the Staged Repair: If the surgeon There is no harm to your baby with a vaginal baby’s . delivery. A C-section is indicated only when determines that placing the intestine into the abdomen will there are unusual obstetrical indications. Pumping and freezing breast milk is create too much pressure and encouraged, as breast milk is especially compromise the bowel and The doctors at the hospital you chose for the benefi cial for babies with special medical breathing, the intestines will be birth of your child will contact the Children’s needs. The NICU sta will help you with treated with a plastic pouch, often Hospital Oakland Neonatal Intensive Care pumping breast milk and its storage. Unit (NICU) regarding the expected delivery called a “silo” bag. The bag not time and notify our transport team in order only protects the intestine but also The length of hospital stay is di erent to prepare for the transfer of your baby. Prior allows gravity to gradually help the for every baby. After discharge from the to transfer to Children’s Hospital Oakland, the intestine into the abdomen. The hospital your baby will be monitored delivery room team will assess your baby’s surgeons will add gentle pressure closely by his or her pediatrician to ensure breathing, place an IV and a gastric tube (a every day to further aid in this appropriate growth and development. tube that runs from the nose or mouth into process. Surgical closure of the Your baby will also be seen every few the stomach) to decompress the intestine. abdomen will then be scheduled months by the pediatric surgeon. They will place a protective covering over the when ready, usually within a week. exposed abdominal contents during transport. All babies are di erent, but babies with The Children’s Hospital Oakland team will then gastroschisis and no other birth defects transfer your baby directly to the NICU, where typically have normal growth and both neonatologists and pediatric surgeons will development.

Image Source: Center for Disease Control and Prevention Disease Control for Center Image Source: assess your baby.

CHILDREN’S FETAL MEDICINE PROGRAM 510-428-3156 Email: [email protected] www.childrenshospitaloakland.org