Gastroshiza (gastroschisis) is a congenital disability where a baby is born with intestines exposed outside the body. This article covers its causes, diagnosis, treatment options, and the long-term outlook for affected children.
What is Gastroshiza?
Gastroshiza, also known as gastroschisis, is a rare congenital disability that affects a baby’s abdominal wall. In simple terms, it means that the baby is born with some of their intestines, or sometimes other organs, protruding from a hole in the abdominal wall. Unlike other similar conditions, such as omphalocele, these organs are not enclosed in a sac. Instead, they are exposed to the surrounding environment, including amniotic fluid, which can lead to infections and other complications if not treated quickly.
This condition is more common than you might think, although still considered rare. In fact, the number of babies born with gastroshiza has been rising in some parts of the world. Thanks to modern medical advancements, though, the chances of survival and living a healthy life are high if the condition is diagnosed early and treated properly.
Causes of Gastroshiza
The cause of gastroshiza is still not fully understood, but several factors may increase the likelihood of a baby being born with this condition. These include:
- Maternal Age: Research shows that younger mothers, particularly those under 20 years old, are more likely to have a baby with gastroshiza. However, it’s not clear exactly why age plays a role in this.
- Substance Use: Smoking, drinking alcohol, and using recreational drugs during pregnancy can all increase the risk. These substances can interfere with normal fetal development, making it more likely for a defect like gastroshiza to occur.
- Environmental Exposure: Pregnant women who are exposed to certain toxins or pollutants—either through work, lifestyle, or living conditions—might have an increased chance of having a baby with gastroshiza.
- Infections: Some infections during pregnancy, such as urinary tract infections or sexually transmitted infections, have been linked to higher rates of gastroshiza. While not all infections lead to this defect, it’s a risk factor that cannot be ignored.
Despite these known risk factors, the condition can still happen in pregnancies with no apparent cause or risk.
How is Gastroshiza Diagnosed?
Gastroshiza is often detected before birth, thanks to prenatal screening. The two most common methods for diagnosing the condition are:
- Ultrasound: This is the most common method of detecting gastroshiza. During an ultrasound, doctors can spot the exposed organs, typically visible as loops of intestines floating outside the abdominal wall. A skilled technician can spot this during a routine scan, often around the 20-week mark of pregnancy.
- Maternal Serum Alpha-Fetoprotein (AFP) Test: This blood test measures the amount of alpha-fetoprotein, a protein produced by the baby. Higher levels of AFP in the mother’s blood may suggest that the baby has a congenital disability like gastroshiza. If the test comes back positive, further diagnostic tests like an ultrasound are usually done.
If gastroshiza isn’t detected through prenatal testing, it is usually apparent at birth. The baby’s condition is immediately evident due to the exposed intestines.
Treatment of Gastroshiza
After birth, a baby with gastroshiza requires immediate medical attention. The primary goal is to protect the exposed organs, stabilize the baby, and prepare for surgery to repair the defect. Here’s what typically happens:
1. Immediate Care After Birth
Once the baby is born, the exposed intestines are covered with sterile, moist bandages to protect them from infection and dehydration. This is often done right away to prevent any further damage. The baby will also be given intravenous (IV) fluids to keep their body hydrated and to supply necessary nutrients, since they won’t be able to feed through the mouth initially.
2. Surgical Repair
The next step is surgery. Surgery is required to place the exposed intestines back into the abdominal cavity and close the hole in the abdominal wall. There are two main approaches to surgery:
- Primary Repair: If the defect is minor and the organs are healthy, a single surgery can be done to place the organs back inside the abdominal cavity and close the wall.
- Staged Repair: In cases where the defect is significant, a staged approach may be required. The intestines are gradually placed back inside the abdomen using a device called a silo. Over a few days, the intestines are carefully pushed into the abdominal cavity before the hole is closed.
The timing of surgery depends on how stable the baby is, but the goal is always to repair the defect as soon as possible to prevent complications.
3. Post-Surgery Care
After surgery, the baby will be monitored closely in a neonatal intensive care unit (NICU). They may stay there for a few weeks or longer, depending on their recovery. Babies who’ve had surgery for gastroshiza will likely face some challenges after the procedure, including feeding difficulties and the potential for digestive issues like blockages or narrowing of the intestines.
In some cases, the baby may need long-term nutritional support, either through a feeding tube or IV nutrition, until their digestive system can function correctly.
Long-Term Outlook
The long-term outlook for babies born with gastroshiza has improved significantly due to advances in neonatal care. Most children who undergo surgery for gastroshiza grow up to be healthy, though there can be some ongoing challenges.
1. Feeding and Nutrition
One of the most common long-term issues for babies with gastroshiza is feeding. Some babies have trouble digesting food or absorbing nutrients, so they may need feeding tubes or specialized nutrition in their first few months or years. In rare cases, the baby may develop long-term issues like short bowel syndrome, which can require ongoing care and adjustments to their diet.
2. Growth and Development
Most children with gastroshiza grow and develop normally. However, they may need regular follow-up appointments to monitor their growth and development. Some children may experience developmental delays, but many do well with the proper support.
3. Medical Follow-Up
Even after surgery and recovery, children who had gastroshiza will need ongoing medical care. Regular check-ups with pediatricians and specialists are important to make sure the child is growing normally, developing well, and that their digestive system is functioning properly.
FAQs About Gastroshiza
Q: Can gastroshiza be prevented?
Unfortunately, gastroshiza can’t always be prevented. However, there are steps that expectant mothers can take to reduce their risk, such as avoiding smoking, alcohol, and drugs, getting early prenatal care, and avoiding exposure to harmful chemicals or infections.
Q: Is the surgery risky?
Like any surgery, there are risks involved. But the survival rate for babies who undergo surgery for gastroshiza is high, especially with early treatment and careful post-surgical care.
Q: What happens if gastroshiza is not treated?
Without treatment, the exposed organs are vulnerable to infection, dehydration, and other complications. In severe cases, this can lead to life-threatening issues. Early diagnosis and surgery are crucial for improving outcomes.
Conclusion
Gastroshiza is a serious condition, but with timely diagnosis and proper treatment, babies born with it can go on to lead healthy lives. Early detection through prenatal screening is key to ensuring the best outcome. If you’re expecting a baby and are concerned about gastroshiza, talk to your doctor about your risks and the steps you can take to protect your baby’s health. While the road to recovery might not always be easy, advances in medical care have made it possible for many children to thrive after surgery.