Gastroschisis treatment in Denver
Gastroschisis is a type of abdominal wall abnormality in which the stomach and bowel come out through a hole in the abdomen. This congenital abnormality is life-threatening if left untreated, but the expert perinatologists, pediatric surgeons and neonatologists at the Center of Maternal/Fetal Health at Rocky Mountain Hospital for Children (RMHC) in Denver are specially trained to diagnose and perform advanced surgical techniques to treat this rare condition.
Additionally, our staff and facility are uniquely equipped to handle the careful treatment of your baby’s health during pregnancy as well as during and after birth.
To find an expert perinatologist or pediatric surgeon, please call (720) 754-4902.
Learn more about gastroschisis
For unknown reasons, the abdominal wall of some babies does not close properly during pregnancy. An estimated one in 5,000 babies will be born with a hole in the abdominal wall, usually measuring less than two inches in diameter and on the right side of the belly button, through which abdominal organs, such as the intestines and stomach, come out of the body.
Though similar to another abdominal congenital condition, omphalocele, this type of congenital abnormality does not have a sac housing the organs. Instead, they are free floating in amniotic fluid and are exposed after birth. Gastroschisis is not thought to be genetic or associated with other chromosomal abnormalities. It does, however, occur more commonly in pregnancies for younger mothers. It is very rare to see a gastroschisis baby in a mother older than 30 years old.
Complications of gastroschisis include poor fetal growth, decreased amniotic fluid, preterm delivery and stillbirth. Additionally, prolonged exposure to amniotic fluid may cause the intestine to swell, shorten or become damaged. The blood supply also may be compromised and an intestinal blockage may occur.
Gastroschisis diagnosis
Gastroschisis is often diagnosed during pregnancy through routine blood work or ultrasound. An increase in alpha fetoprotein levels for the triple screen or quad screen blood tests is an indicator of this condition. Once the condition is diagnosed, our highly experienced perinatologists carefully monitor the pregnancy to check fetal growth and create a plan for treatment.
Treating gastroschisis
Pediatric surgery is always the appropriate treatment for gastroschisis. Typically, the mother’s labor will be induced between 35 and 37 weeks of gestation due to the increased risk of stillbirth. A vaginal delivery is possible, but a C-section may be desirable. Your perinatologist will work with you to decide the best delivery method for your baby.
It is important to plan delivery at a facility equipped to handle the unique needs of a high-risk newborn with a Level IV Neonatal Intensive Care Unit (NICU). After birth, an experienced team of neonatologists, pediatric surgeons and dedicated neonatal staff should be present.
Immediately following delivery, the team will cover the organs with special material to keep them moist and warm. Surgery usually takes place within hours after birth to place the intestines back into the abdomen.
The surgeons of Rocky Mountain Pediatric Surgery are experienced in the treatment of abdominal wall abnormalities. If the newborn’s organs are not damaged or significantly swollen, the team places the organs back into the abdomen and closes the herniation (hole). This is called primary gastroschisis repair.
If the organs have sustained damage or are very swollen, a staged gastroschisis repair is made. A silastic (silicone plastic) pouch, also called a silo, is placed around the herniated organs. Each day, the silo is tightened and some of the bowel is pushed back into the body. Once all of it is in the body, usually taking about five to 10 days, the silo is removed and the opening is closed surgically.
Long-term outlook
After surgery, babies with gastroschisis will require help breathing due to the increased pressure the replaced bowel has on the diaphragm. Breathing assistance usually is required for about three days. Then, most babies stay in the NICU for another six to 12 weeks, learning how to eat properly.
Gastroesophageal reflux disease is sometimes present after treatment, but it can be well-managed with medication and most babies make a full recovery, going on to live happy, healthy lives.