It’s something no parent ever wants to experience – having an infant born with organs outside his or her body, and being immediately whisked off to surgery.
Gastroschisis, is a serious birth defect where an abnormal opening occurs in the abdominal wall, usually to the right of the belly button (umbilicus), which allows the uncovered intestines to spill out. During fetal development, the abdominal wall fails to close properly, leaving an opening.
In the early stages of pregnancy, the intestine develops within the umbilical cord. Weeks later it moves inside the foetus’ abdomen. But where an unborn child has gastroschisis, the abdominal wall does not completely form. It results in the intestines growing outside the body.
Another similar situation called Omphalocele is caused by an opening (defect) in the middle of the abdominal wall at the bellybutton. Both are diagnosed by prenatal ultrasonography; surgical closure is the treatment of choice.
Gastroschisis is more common among younger mothers, and the prevalence of the defect had nearly doubled between 1995 to 2005. Its more disturbing that the prevalence is still increasing, and it’s correlated to race as well, the largest being non-Hispanic black mothers who were less than 20 years old.
Causes and Risk Factors
The exact causes of the defect are still unknown, but CDC researchers have reported that some factors like alcohol or tobacco consumption, certain medications or some other environmental factors that the mother comes in contact during pregnancy may contribute to this defect.
Understanding factors that are more common among babies with a birth defect will help us learn more about the causes, CDC says.
Prenatal ultrasound, where the bowel and perhaps the liver will be seen floating in the amniotic fluid.
Problems associated with Gastroschisis
The only problems that are common with these babies are related to their gastrointestinal system:
- Malrotation (bowel is not in correct position)
- Atresia (passage is blocked)
- Volvulus (twisting of the bowel than can lead to the blood supply can being cut off)
- Infarction (blood supply has been cut off, and that area will be damaged)
Once the baby is born, the internal organs will be exposed to air and unprotected. This makes the bowel more susceptible to infection and immediate surgery is done to put the organs back inside the baby’s abdomen.
If possible, the entire bowel will be put back into the abdominal cavity during this surgery. This is referred to as a “primary closure.” If the intestines do not all fit, the remaining exposed bowel is placed in a sac or “silo” and then put the intestines back into the baby’s abdomen gradually. The abdominal wall will be closed at a later time, once all the bowel is in the abdomen.
But even after the surgery, which puts the intestines in place and repairs the abdominal wall, babies might still have trouble eating and digesting. That condition can carry into adulthood.
Gastroschisis sounds terrifying and can be life threatening, but is actually treatable with surgery says Dr. James Greenberg, who is the co-director of the Perinatal Institute and director of Neonatology at Cincinnati Children’s Hospital Medical Center.
“This can be picked up on a routine second trimester ultrasound. An 18-week ultrasound can identify this. For the caretakers, knowing ahead of time is very valuable for these babies,” he said.
Here are some of the stories told by mothers of affected children –
One such mother of the affected child, Brooke explains about her daughter Anna, who was born with gastroschisis. Brooke tells how doctors had to whisk Anna away almost immediately after she was delivered for surgery to restore her large intestine and a fallopian tube to her abdomen.
“It was about a week before they attempted giving her my pumped breast milk through a bottle,” Brooke wrote. “She took to it quickly but would soon fall asleep or lose interest. Eventually she was eating a decent amount, and the doctors and nurses were pleasantly surprised with her very rapid progress.”
“After only 17 days in the NICU, our little Anna was released and sent home with us,” Brooke continued. “It was as if a great weight had been lifted off our hearts and shoulders … our little girl was home!”
Another mom, Tiffany, wrote that while her daughter Genevieve is now nearly 3 years old, she continues to struggle with hydration and nutrition due to gastroschisis and will always have to watch her for signs of problems (Fox News).
Maisie Tobin looks like a happy four-month-old now,who is born with same defect. Her parents were were told their baby had gastroschisis at their 12-week-old scan and she was closely monitored and delivered by Caesarean section.
Seconds after she was born doctors wrapped her in cling film to keep her organs close to her body and prevent infections. She was then immediately rushed for an operation to put her bowel back into her body, and surgeons also created a scar to look like a belly button as she was born without one. Now, she is finally at home with her parents and five-year-old sister Elouise, and is thriving (Dailymail).
“Scientists do not know why it is happening more and more as the cause is still unknown. Public health research is urgently needed to figure out the cause and why certain women are at higher risk of having a baby born with gastroschisis,” the CDC’s Coleen Boyle said in a statement.