How is gastroschisis diagnosed and treated?

July 27, 2020

Gastroschisis is a birth defect of the abdominal (belly) wall this is becoming more common. It can be found during pregnancy or after your baby is born.

Diagnosing gastroschisis

You may find out your baby has gastroschisis from a routine prenatal test (medical tests you get during pregnancy) that checks your baby for birth defects. Your health care provider also may check your baby for gastroschisis if you have a condition called polyhydramnios during pregnancy.

Your provider may use these tests to diagnose gastroschisis during pregnancy:

  • Fetal echocardiogram (also called fetal echo). This test uses ultrasound to make a picture of your baby’s heart while still in the womb. Some babies with gastroschisis also have heart problems.
  • Maternal blood screening (also called quad screen). This screening test measures four substances in your blood: alpha-fetoprotein (also called AFP), estriol, human gonadotropin (also called hCG) and inhibin A. The test is done at 15 to 22 weeks of pregnancy. If you have high levels of AFP, your baby may have gastroschisis.
  • Magnetic resonance imaging (also called MRI). This is a medical test that uses a large magnet and radio waves to make a detailed picture of the inside of the body.
  • Ultrasound. This test uses sound waves and a computer screen to show a picture of your baby inside the womb. If your baby has gastroschisis, an ultrasound may show the bowels floating outside of your baby’s belly. You may need several ultrasounds during your pregnancy so your provider can monitor the intestines and other organs as your baby grows, checking for any changes to them.

If gastroschisis isn’t found during pregnancy, your provider can diagnose it at birth.

How is gastroschisis treated?

Gastroschisis can’t be treated during pregnancy. Soon after your baby is born, he needs surgery to put his organs back inside the body. Your baby can’t survive without surgery. Most of the time, gastroschisis can be fixed with one or two surgeries.

Gastroschisis treatment depends on your baby’s health at birth. There are two types of treatment:

  1. Primary gastroschisis repair is used if only some of the intestine is outside of your baby’s belly and it’s not very swollen. This surgery puts the intestine back into the belly and closes the hole.
  2. Staged repair fixes your baby’s gastroschisis defect slowly, in stages. Staged repair is used if many organs are outside the belly or your baby isn’t healthy enough for primary repair. Your baby also may have staged repair if the intestine is very swollen, there’s a large amount of intestine outside the body or his belly isn’t big enough to hold all of the intestine.

After recovering from surgery, most babies with gastroschisis live normal lives. Some children may have problems with digestion later in life.

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