What is gastroschisis?
The word Gastrochisis comes from two Greek words, “gastro” meaning stomach, and “schisis” to split.
Gastroschisis is a condition where the baby has a hole in the abdominal wall near the belly button and the bowel (and sometimes other organs) develops outside the abdomen.
The bowel can then float freely outside of the belly in the water in the sac around the baby (amniotic fluid), as it is not protected by the skin, over time it can become irritated.
We don’t know why gastroschisis happens, the exact cause is unknown. It is rare and occurs once in every 2000 to 3000 pregnancies.
It may occur due to a disruption in blood flow to the abdominal wall early in development. It is found more often in young women and those who smoke or use drugs, but often women who have a baby with gastroschisis have no risk factors at all.
Gastroschisis is not usually seen with other genetic differences.
Gastroschisis is screened for at the 20-week anomaly scan. However, it is often diagnosed earlier at the dating scan (11-14 weeks)
The scan shows loops of bowel floating outside the baby’s tummy.
- You will be referred to the fetal medicine team and have regular scans in pregnancy.
- Babies with gastroschisis all need regular growth surveillance.
- You may need to be delivered in a different hospital with specialist neonatal and surgical facilities as your baby is likely to need surgery after delivery.
- Gastroschisis is not usually associated with genetic or chromosome differences; however, if any other differences are seen, you may be offered genetic testing.
- You are likely to be offered earlier delivery.
Babies with gastroschisis usually need surgery after birth to place the bowel back into the tummy. Your baby will be cared for in a neonatal intensive care unit. Surgery is done soon after birth. The bowel may be placed back in all at once or gradually over several days, depending on the size of the defect.
A specialist baby doctor (neonatologist) will be present at the time of birth and your baby will be cared for in the neonatal unit (NICU) after delivery.
Your baby’s bowel will be covered in a bag or film. Your baby will also be started on antibiotics to reduce the risk of infection.
A specialist surgeon will assess your baby and discuss the options for treatment with you. Most babies with gastroschisis will have one of two treatments:
Around 1 in 10 babies with gastroschisis have an associated blockage in their bowel, called an atresia. This may only become obvious several weeks after the gastroschisis has been closed and will need further surgery.
Very rarely babies who are diagnosed during your pregnancy with gastroschisis are born with no defect and no bowel on the outside of their body. This usually means that the defect closed before they were born and that they may have lost some of their bowel. These babies usually need an operation to join the remaining bowel back together.
After the operation, your baby will be closely monitored in NICU or on the surgical ward. Your baby will need support.
Sometimes it can take many weeks before the bowel starts working properly.
Babies with gastroschisis are also at an increased risk of an illness called necrotising enterocolitis (NEC). This is an infection of the bowel which is treated by resting the gut (not feeding into the stomach) and giving antibiotics.
Most cases are not inherited, and the chance of it happening again is very low.
Abdominal wall defects: gastroschisis information for parents - GOV.UK
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