Was your baby born with a small part of his intestines sticking out? It's normal for any mother or father to be worried when they see something like this. But if you are properly informed about this, there is nothing to worry about. Today, let's talk about this condition called Gastroschisis. This may sound like a big disease when you hear it, but let's talk about it simply.
What is Gastroschisis? Let's understand it simply
Imagine, when a baby comes into this world, a little of its intestines (that is, the stomach, small intestine, and large intestine) are protruding? That's what we call gastroschisis. This is a congenital condition. This intestine comes out of a small hole in the baby's abdomen, usually about 2 to 5 centimeters, just beyond the umbilical cord.
This happens early in the baby's life. That is, when the baby's abdominal wall is not fully formed, a small gap is left, and this organ protrudes through it. Then, the intestines that have come out float in the amniotic fluid, which is a watery liquid inside the mother's uterus. Because of this, sometimes these organs can swell a little and cause minor infections.
The most important thing is that in this situation, surgery is definitely needed to put the baby's organs back inside the body and close the hole.
What is the difference between Gastroschisis and Omphalocele?
There is another birth defect called Omphalocele. It also involves the baby's abdominal organs protruding out. But there is a slight difference between the two.
- Gastroschisis: Here, the intestines come out without any covering. This means that the intestines are directly visible.
- Omphalocele: Here, the protruding organs are covered by a thin membrane .
Doctors can often detect this difference during an ultrasound examination before the baby is born.
Who is most likely to be affected by this situation?
The exact cause of gastroschisis has not yet been found. This means that any pregnant woman has a chance of developing it in her baby. However, some studies (for example, studies by the Centers for Disease Control and Prevention - CDC) have shown that certain factors may increase the risk. These include:
- Mothers who become pregnant at a very young age: That is, those who become mothers at a young age.
- Tobacco use, alcohol consumption, or other drug use during pregnancy.
These are the risk factors that have been identified so far. But remember, this condition can also occur in people who do none of these things.
How common is gastroschisis?
This is a very rare condition. For example, in America, this condition affects about one in 2,000 babies born each year. This is not uncommon in Sri Lanka either.
What are the symptoms of Gastroschisis?
The mother may not experience any symptoms during pregnancy due to this condition. However, ultrasound scans may show the following on the baby's side:
- The baby's stomach, small intestine, or large intestine appears to be outside the body .
- The intestines that came out may be swollen .
- Sometimes the intestines can be twisted together .
- After the baby is born , his body temperature may drop (hypothermia).
What causes gastroschisis?
As mentioned earlier, the exact cause of this is not yet known. It's just that: As the baby grows in the womb, the wall of the womb doesn't fully form. That's the main reason for this. If you're planning to get pregnant, it's important to talk to your doctor about ways to prevent birth defects.
How is Gastroschisis diagnosed?
This condition is diagnosed either during pregnancy or after the baby is born. It is most often detected during routine tests performed between 18 and 20 weeks of pregnancy. What are these tests?
- Ultrasound: This test uses sound waves to clearly see the tissues inside your body, as well as the baby. It can also show if the intestines have come out.
- Blood screening: Certain substances in the mother's blood are measured. In particular, if the level of a protein called alpha-fetoprotein is higher than normal (especially between 18-22 weeks), it may be a sign of a condition called gastroschisis.
- MRI (Magnetic Resonance Imaging) test: This is also an imaging test. It can take clearer, more detailed pictures of the inside of your body and your baby. Not everyone needs this, but doctors may recommend it in some special cases.
How is Gastroschisis treated?
Even if this condition is diagnosed during pregnancy, treatment can only begin after the baby is born.
Surgery is mandatory. This surgery involves putting the baby's organs back inside the body and closing the hole near the umbilical cord. This will stop the organs from coming out again.
Depending on the severity of the baby's condition and how many organs have protruded, there are two types of surgery:
1. Primary repair: If possible, surgery is performed as soon as the baby is born and the organs are inserted to close the hole in the abdomen. This is what is most often attempted.
2. Staged repair: If the gastroschisis is a bit more complicated, meaning the baby is not healthy enough to withstand surgery, or there is not enough room in the baby's abdomen to accommodate all of these organs at once, the surgeon will perform this surgery in stages.
From the time the baby is born until the operation, the baby's surgeon covers the emerging organs in a special plastic bag called a silo . This prevents the organs from becoming infected, drying out, and becoming damaged.
After the initial surgery, sometimes more surgeries may be needed to rebuild the baby's stomach muscles or intestines.
Are there any complications after surgery?
Yes, there are some complications that can occur after gastroschisis surgery. What are they?
- Infection at the surgical site.
- Difficulty eating.
At times like this, the baby may need to be fed either through an intravenous (IV) line, such as saline , or through a nasogastric tube until they are able to eat properly again.
Can intestinal problems occur after gastroschisis treatment?
About 25% of babies born with gastroschisis may have some problems with the development of their intestines. This may require additional surgery to treat. Examples:
- Bowel resection: Surgical removal of damaged parts of the intestine.
- Ileostomy or Colostomy: This involves removing one end of the intestine from the abdominal wall and placing a bag there to collect stool. This is not necessary for everyone, only in special cases.
What are the side effects of Gastroschisis?
Babies born with gastroschisis may face some health problems throughout their lives:
- Premature birth: Babies with gastroschisis can often be born prematurely.
- Intestinal blockage: After surgery, the baby's intestines may become narrow in some places, which can cause food and stool to not pass through properly.
- Short bowel syndrome: This is a very rare condition. Some babies have fewer parts of their intestines, which can make it difficult for them to properly absorb nutrients from food.
When can I take my baby home after gastroschisis surgery?
Depending on the severity of the baby's condition, he or she may need to stay in the hospital's Neonatal Intensive Care Unit (NICU) for a period of two weeks to several months. This time is determined by carefully monitoring the baby's wounds to see if they are healing well and if they are able to eat and digest food properly. Sometimes, if additional surgeries are needed, the hospital stay may be longer.
How can I reduce the risk of having a baby with gastroschisis?
Although this risk cannot be completely eliminated, following some things can help reduce the risk:
- Avoid smoking and using tobacco products.
- Do not drink alcohol during pregnancy.
- Do not use painkillers (especially opioids) during pregnancy without medical advice.
- Eat a nutritious, balanced diet .
Following these is very important for your health as well as your baby's.
What should I expect if my baby has gastroschisis?
As soon as the baby is born, surgery is needed to close the abdomen by putting in his organs. If the hole in the abdomen is large, doctors will put in the organs little by little over a few days or weeks after the baby is born.
After surgery, your baby will be given IV (intravenous) nutrients and antibiotics to prevent infection until he or she recovers. You cannot give your baby breast milk or formula right after the surgery. Your doctor will tell you when you can start giving your baby breast milk/formula.
In most cases, if your baby has only a condition called gastroschisis, he or she will make a full recovery and grow up just like any other baby. However, there is a small risk of developing some digestive complications later in life. Your doctor will talk to you about this.
How do you deliver a baby with gastroschisis?
It is best to deliver your baby in a hospital with a neonatal intensive care unit (NICU) and doctors who specialize in treating these conditions. Babies with gastroschisis can usually be delivered vaginally or by cesarean section (C-section). Your obstetrician will help you decide which method is best for your baby.
When should I see the doctor after surgery?
After surgery, you should see a doctor immediately if your baby has any of these symptoms:
- If the surgical site is swollen and red .
- If something like fluid is leaking from the surgical site.
- If you are vomiting or if you are not passing stool properly.
These could be signs of an infection or other complication, so it's important to seek treatment quickly.
What questions should I ask my doctor?
At a time like this, you may have many questions. Don't be afraid to ask your doctor. Here are some examples:
- What are the long-term complications of gastroschisis?
- How long will my baby stay in the hospital after the surgery?
- When can I start giving my baby breast milk or formula?
It can be scary to see your baby's organs come out when they're born. However, your baby has a much better chance of recovering after the surgery to put the organs back in. Your medical team will explain everything to you and guide you through the surgery and recovery process.
## Take-Home Message
- Gastroschisis is when a baby's intestines, like organs, emerge through a small hole in the stomach.
- I don't know the exact reason for this.
- This can be detected through ultrasound tests during pregnancy.
- The treatment is to perform surgery to insert the organ and close the hole.
- Most babies recover completely from this condition and develop normally.
- To reduce the risk, it is important to follow a healthy lifestyle during pregnancy.
- If you have any questions or concerns, don't be afraid to talk to your doctor. They will help you.
I hope this information is helpful to you. Remember, you are not alone. Doctors and nurses are always there to help you and your baby.
` Gastroschisis, birth defects, intestinal prolapse, baby health, pregnancy, neonatal surgery, neonatal care
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