By Nike Carkarel 
What is Gastroshiza
Gastroshiza is a rare but serious congenital condition in which a baby is born with an opening in the abdominal wall, typically located to the right of the belly button. Through this opening, the intestines and sometimes other organs develop outside of the baby’s body. Unlike other abdominal wall defects, gastroshiza is not enclosed by a protective membrane, which leaves the organs exposed to amniotic fluid during pregnancy. This exposure can lead to inflammation and other complications. Early diagnosis and prompt surgical treatment are essential to ensure a good prognosis.
Understanding the Causes of Gastroshiza
The exact cause of gastroshiza is still under investigation, but medical experts believe that both genetic and environmental factors play a role. Here’s a closer look at what may contribute to the development of gastroshiza:
1. Vascular Disruption
One theory suggests that an interruption in blood flow to the developing abdominal wall during early pregnancy may cause the wall to form improperly. This disruption may prevent the abdominal muscles from closing completely.
2. Maternal Factors
Research has linked certain maternal behaviors and conditions to an increased risk of gastroshiza:
-
Teenage pregnancy: Women under the age of 20 are more likely to have a baby with this condition.
-
Smoking or drug use during pregnancy: Harmful substances can interfere with fetal development.
-
Poor prenatal nutrition: Inadequate folic acid intake may contribute to developmental defects.
3. Environmental Exposure
Exposure to certain chemicals or pollutants during pregnancy could also increase the risk of abdominal wall defects, including gastroshiza.
Recognizing the Symptoms of Gastroshiza
Here are the key symptoms to watch for:
1. Visible Organs Outside the Abdomen
At birth, the most obvious sign of gastroshiza is the presence of intestines and possibly other organs protruding through an opening near the umbilical cord.
2. Bowel Damage
Because the exposed intestines float freely in amniotic fluid during pregnancy, they can become inflamed, twisted, or shortened. This can lead to digestion issues after birth.
3. Feeding Difficulties
Infants with gastroshiza often cannot feed normally right away. They may require nutrition through intravenous lines until the digestive system recovers.
How Is Gastroshiza Diagnosed?
Most cases of gastroshiza are diagnosed through routine prenatal screening. The earlier it’s detected, the better prepared doctors can be to treat it at birth.
1. Prenatal Ultrasound
A detailed ultrasound, usually done around 18-20 weeks of pregnancy, can detect the presence of exposed intestines outside the baby’s abdomen. This is the most common method for identifying gastroshiza.
2. Elevated AFP Levels
Mothers carrying babies with gastroshiza often have elevated levels of alpha-fetoprotein (AFP) in their blood. High AFP levels may prompt additional imaging tests.
3. Fetal MRI (in rare cases)
If the ultrasound results are unclear, doctors may recommend a fetal MRI to gather more detailed information about the defect and other possible complications.
Treatment Options for Gastroshiza
Gastroshiza requires prompt surgical treatment after birth. With modern medical advancements, the survival rate for infants born with this condition is high.
1. Initial Stabilization
Immediately after birth, the baby’s exposed organs are covered with a sterile dressing to protect them from infection and dehydration. The baby is placed in a neonatal intensive care unit (NICU) for monitoring and stabilization.
2. Surgical Repair
There are two main approaches to surgically treating gastroshiza:
-
Primary Repair: If the abdominal cavity is large enough, the intestines are placed back into the abdomen in one surgery.
-
Staged Repair (Silo Method): If the intestines are too swollen or large, they are placed into a silo—a special pouch that gradually moves the organs back inside over several days.
3. Post-Operative Care
Recovery from gastroshiza surgery includes:
-
Monitoring for infection
-
Managing fluid levels
-
Gradually introducing feeding via a tube
-
Administering pain relief and antibiotics
Long-Term Outlook for Children with Gastroshiza
With early intervention and proper care, most babies with gastroshiza recover and go on to live healthy lives. However, some children may experience long-term complications.
1. Digestive Problems
Some children may suffer from:
-
Malabsorption
-
Chronic constipation
-
Intestinal obstruction
These issues can often be managed with medication and dietary changes.
2. Growth and Development
Infants who have undergone treatment for gastroshiza may take longer to catch up with developmental milestones but typically reach them over time with supportive care.
3. Regular Follow-Ups
Ongoing visits with pediatricians and gastroenterologists are essential to monitor the child’s growth and gut function.
Prevention and Maternal Health
Though gastroshiza cannot always be prevented, certain steps may reduce the risk:
1. Healthy Lifestyle Choices
Avoid smoking, alcohol, and drug use before and during pregnancy.
2. Nutritional Support
Take prenatal vitamins, especially those containing folic acid, to support proper fetal development.
3. Early Prenatal Care
Regular visits to a healthcare provider can help detect abnormalities early and ensure timely medical planning.
Final Thoughts on Gastroshiza
Gastroshiza is a serious yet manageable condition that affects newborns. Thanks to advances in prenatal screening and neonatal surgery, most babies with gastroshiza go on to thrive. Awareness of this condition, its causes, and treatment options helps parents make informed decisions and prepare for the care their baby may need. With proper medical attention, the outlook is promising.