Gastroschisis

For prenatal gastroschisis, the specialist team at our Center for Fetal Care provides exceptional care for you and your baby throughout pregnancy and delivery. We keep your baby safe until it’s possible to make needed repairs.

Care starts with high-risk pregnancy experts who guide you and your baby throughout pregnancy and delivery. Pediatric surgeons at Advocate Children’s Hospital then ensure your baby has a healthy start to life.

Learn more about what to expect when you come to us for your baby’s care.

What is gastroschisis?

Gastroschisis is a condition in which a baby’s abdominal organs are outside the baby’s body. The condition is congenital, or present in some newborns. Without special care during delivery and repair soon after birth, it can threaten a baby’s life.

In the womb, certain organs normally develop outside a baby’s body, by pushing through an opening in the abdominal wall. These organs can include the intestines, bladder, liver, stomach, and ovaries or testes. They should eventually go back into the body as the hole closes. With gastroschisis, some organs don’t return, and the gap remains open.

What causes gastroschisis?

The exact causes of gastroschisis aren’t completely understood. Research suggests that a combination of genetic and environmental factors may play a role.

Gastroschisis symptoms and signs

Women are at higher risk of preterm delivery when their baby has a gastroschisis. Ultrasound can be used to show the main sign of the condition – an organ (or organs) seen outside, rather than inside, your baby’s body.

Gastroschisis diagnosis

Doctors can see a baby’s protruding organs before birth, as early as 12 weeks, using 3D ultrasound. When a baby has exposed bowels, as with gastroschisis, testing the mother’s blood can show higher levels of a specific protein called alpha-fetoprotein.

We also refer you to our genetics program for a consultation and evaluation. Find out more about imaging and other tests we use to diagnose fetal conditions.

Gastroschisis treatment

If we detect gastroschisis through a prenatal ultrasound, we monitor you closely to make sure your baby is otherwise healthy. Together, you and your doctors decide whether to have a vaginal or cesarean section delivery.

We then plan your baby’s treatment ­– surgery after birth to return the intestines (or other organs) to the belly. If only a small amount of intestines are outside, we often put them back shortly after delivery and close the opening.

In many cases, though, the baby’s belly is too small for the intestines to fit at once. Our neonatal and pediatric surgeons do a staged repair to gradually ease them back in. We place a silo (special mesh bag) over the intestines and attach it to the edges of the opening. Over several days, we slowly tighten the silo to guide the intestines back into the belly. We then close the opening.

During staged repair, your baby receives other treatment, including:

• Antibiotics to prevent infection
• Breathing tube for the lungs to expand
• Regulation of body temperature, because the exposed intestines release heat
• Intravenous (IV, through a vein) nutrition until the intestines are ready to digest food on their own

Follow-up care for gastroschisis

With gastroschisis, the intestines touch the amniotic fluid that surrounds the baby in the womb. This exposure may damage the intestines, and it can take several weeks for them to recover. Your baby may need to continue with IV nutrition before slowly transitioning to breast milk or formula.