Gastroschisis (pronounced gas-troh-skee-sis) is a birth defect of the abdominal wall. The baby’s intestines stick outside of the baby’s body, through a hole beside the belly button.
This week I wanted to inform you of something I have learned about recently because of this little patient that was brought to us at a day old. We sent the baby and her parents to Jalingo to the best hospital to care for the baby in our area ( 4-6 hours away) and chances are she did not survive.
Gastroschisis is a birth defect of the abdominal (belly) wall. The baby’s intestines stick outside of the baby’s body, through a hole beside the belly button. The hole can be small or large and sometimes other organs, such as the stomach and liver, can also stick outside of the baby’s body.
Gastroschisis occurs early during pregnancy when the muscles that make up the baby’s abdominal wall do not form correctly. A hole occurs which allows the intestines and other organs to extend outside of the body, usually to the right side of belly button. Because the intestines are not covered in a protective sac and are exposed to the amniotic fluid, the bowel can become irritated, causing it to shorten, twist, or swell.
Soon after the baby is born, surgery will be needed to place the abdominal organs inside the baby’s body and repair the abdominal wall. Even after the repair, infants with gastroschisis can have problems with feeding, digestion of food, and absorption of nutrients.
Causes and Risk Factors
The causes of gastroschisis among most infants are unknown. Some babies have gastroschisis because of a change in their genes or chromosomes. Gastroschisis might also be caused by a combination of genes and other factors, such as the things the mother comes in contact with in the environment or what the mother eats or drinks, or certain medicines she uses during pregnancy.
Recently through some studies done by CDC (Centers for Disease Control) some common factors have been found such as; Younger age: teenage mothers were more likely to have a baby with gastroschisis than older mothers and Alcohol and tobacco: women who consumed alcohol or were a smoker were more likely to have a baby with gastroschisis.
Gastroschisis can be diagnosed during pregnancy or after the baby is born.
During pregnancy, there are screening tests (prenatal tests) to check for birth defects and other conditions. Gastroschisis might result in an abnormal result on a blood or serum screening test or it might be seen during an ultrasound. Typically in our area of Nigeria where 85% of mothers still birth their babies at home with limited to no pre-natal care this is not typically known until the baby is born.
Gastroschisis is immediately seen at birth. Then treatment can start, if the hospital has adequate equipment and surgical department.
Soon after the baby is born, surgery will be needed to place the abdominal organs inside the baby’s body and repair the defect.
If the gastroschisis defect is small (only some of the intestine is outside of the belly), it is usually treated with surgery soon after birth to put the organs back into the belly and close the opening. If the gastroschisis defect is large (many organs outside of the belly), the repair might done slowly, in stages. The exposed organs might be covered with a special material and slowly moved back into the belly. After all of the organs have been put back in the belly, the opening is closed.
Babies with gastroschisis often need other treatments as well, including receiving nutrients through an IV line, antibiotics to prevent infection, and careful attention to control their body temperature.
Unfortunately, in Nigeria because of medical resources the death rate is over 80%. In developed countries, the death rate is around 10%.
This is just one of the reasons we are here in Nigeria.
My point for today is this: Please pray as we move forward with our surgical and hospital here in Gembu.