Gastroschisis

Gastroschisis: Description, Causes and Risk Factors: A congenital fissure in the abdominal wall not involving the umbilical cord; usually accompanied by protrusion of viscera. GastroschisisGastroschisis is a relatively uncommon condition that occurs in approximately 1 in 5,000 live births. It is one of a group of birth defects known as abdominal wall defects, which occur very early in gestation and are characterized by an opening in the abdominal wall of the fetus. Gastroschisis occurs more often in babies born to younger mothers and the incidence of gastroschisis is increasing Worldwide. While there is no specific known cause of gastroschisis, it does not appear to run in families and the recurrence risk is not higher in future pregnancies. Unlike other abdominal wall defects, such as omphalocele, gastroschisis is typically not associated with chromosomal abnormalities or other structural malformations with the exception of an intestinal blockage (atresia), which occurs in only about 10 percent of infants with gastroschisis. Most cases of this involve the intestine and other abdominal organs herniating (protruding) through an opening (hole) in the abdominal wall and spilling out into the amniotic fluid around the fetus. This opening is usually found to the right of the umbilicus (belly button). As a consequence, the unprotected intestine becomes irritated, causing it to swell and shorten. The longer the exposure to amniotic fluid, the more severely the intestine can become damaged. In addition, as the fetus continues to develop, the tight opening may squeeze the blood supply to the intestine or cause it to twist around itself. Either of these consequences can cause intestinal blockage, loss or malfunction and lead to long-term feeding problems after the baby is born. Current advances in surgical techniques and intensive care management for neonates have increased the survival rate to 90%. Symptoms: If your baby has gastroschisis, you will not notice any signs or symptoms related to the condition in yourself while you are pregnant. Mothers whose babies have gastroschisis, however, may have excess fluid around the baby in the womb, a condition called polyhydramnios. About 1 in 10 babies with it has intestinal atresia, which means part of their intestine has not formed completely. Once your baby is born and the gastroschisis is fixed, the main symptom of the condition is problems with feeding your baby. Often this happens because babies with gastroschisis have shorter intestines than usual. As a result, they may have some trouble absorbing nutrients at first. In time, though, more than 95% of babies that had gastroschisis are able to eat and gain weight normally. Diagnosis: Physical examination of the infant is enough for the Healthcare provider to diagnose gastroschisis. The baby will have problems with movement and absorption in the gut, because the unprotected intestine is exposed to irritating amniotic fluid (AF). The mother may have shown signs of too much amniotic fluid (polyhydramnios). A prenatal ultrasound often identifies the gastroschisis.The diagnosis of gastroschisis is confirmed after routine blood tests show abnormally high alpha fetoprotein levels. Treatment: If gastroschisis is found before birth, the mother will need special monitoring to make sure her unborn baby remains healthy. Plans should be made for careful delivery and immediate management of the problem after birth. Treatment for gastroschisis is surgery to repair the defect. A surgeon will put the bowel back into the abdomen and close the defect, if possible. If the abdominal cavity is too small, a mesh sack is stitched around the borders of the defect and the edges of the defect are pulled up. Over time, the herniated intestine falls back into the abdominal cavity, and the defect can be closed. Other treatments for the baby include nutrients by IV and antibiotics to prevent infection. The baby's temperature must be carefully controlled, because the exposed intestine allows a lot of body heat to escape. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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