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Gastroschisis

Our Fetal Care Center offers comprehensive and advanced diagnostic tests and treatments for rare birth defects such as gastroschisis. Gastroschisis causes a baby’s bowel, and sometimes other organs, to form through a hole in the baby’s abdomen. The baby’s bowel then develops outside the baby’s body in the amniotic fluid.

Extensive experience and expertise allow our team to treat the most complex gastroschisis cases. Our family-centered approach focuses on including you and your family throughout diagnosis and treatment to help you make the best decisions for you and your family. 

Our team also includes a Fetal Therapy Nurse Coordinator who is available to help you and your family through the diagnosis and treatment process. The coordinator will be there for you from the time your physician refers you to us until you give birth to your baby, and often beyond. Our coordinator will guide you through testing, meeting with specialists, scheduling appointments and creating a care plan that works best for you and your family.

Diagnosis

Gastroschisis is most detected at a routine ultrasound around weeks 18-20 of pregnancy. Patients are referred to one of our specialists for further evaluation and diagnosis. An evaluation for gastroschisis usually consists of: 

  • Ultrasound 
  • Fetal echocardiogram to assess your baby’s heart anatomy and function
  • Meeting with a genetic counselor to discuss options for genetic testing
  • Magnetic Resonance Imaging (MRI) 
  • Meeting with a care team which includes specialists within Maternal-Fetal Medicine (MFM), pediatric surgery and neonatology.

Prenatal Management and Birth

We work with you to develop an individualized care plan to provide the best possible outcomes for you and your baby. We closely monitor your pregnancy with frequent ultrasound imaging to keep a close watch for any complications. After birth, your baby will be admitted into our Neonatal Intensive Care Unit (NICU) for assessment and monitoring. 

NICU Stay and Treatment

We created a NICU designed to support family-centered care, enhance outcomes and advance research in neonatology. On arrival to the NICU, your baby will receive 24-hour team coverage. The team evaluates level of breathing assistance needed, monitors medications and nutrition which are given through an IV and will coordinate care services based on your needs. 

Surgical Treatment 

This condition cannot be treated or corrected while you are pregnant. It must be treated right after your baby is born. The type of surgical repair needed will depend on the severity of your baby’s condition.

Primary repair 

Usually, surgery will be done within a few hours after birth. During this procedure, the exposed organs are carefully put back inside the baby’s abdomen, and the abdominal wall is closed during the procedure. 

Staged repair 

If the amount of bowel outside the abdomen is large or very swollen, or if your baby’s condition is unstable, the repair may be done in several steps (stages). In the first stage, a pouch is placed around the bowel that is outside of the baby’s body. Over the next few days, the bowel is then gradually and gently pushed back into the abdomen. Once the bowel is completely inside the abdomen, your surgeon will discuss the options for closing the abdominal wall. 

Follow-Up Care 

Once your baby’s repair is complete, they will continue to be monitored in the NICU. Your baby’s length of stay in the NICU varies and may be longer if your baby was born prematurely or experiences complications. After discharge, your baby will be closely monitored by a pediatrician and have periodic appointments with the pediatric surgeon. Most babies who had gastroschisis can go on to live a healthy life without complications related to the condition.