Gastroschisis

Gastroschisis is a birth defect in which a gap in your baby’s abdominal wall allows the stomach or intestines to protrude outside of the body. The majority of babies with this problem are born to mothers in their late teens or early 20s. Gastroschisis occurs in about one in every 5,000 births. The cause of gastroschisis is unknown.

How is gastroschisis diagnosed?

Gastroschisis is usually detected at the routine 16-20 week screening ultrasound when intestines are seen floating in the amniotic fluid outside the baby’s abdomen.

Although it is important to carefully monitor your pregnancy with ultrasound studies, genetic tests are usually not needed.  Sometimes gastroschisis can produce a bowel obstruction or blockage, which can slow the baby’s growth. Your baby’s growth will be monitored by ultrasound.

If your baby has been diagnosed with gastroschisis, it would be beneficial to schedule a consultation with your family and one of our top surgeons, as well as a CHOC neonatologist and your perinatologist, to prepare for the birth and subsequent care of your baby.

What will happen when my baby is born?

Your perinatologist, a specialist in fetal and maternal medicine, will discuss your delivery plans. Most babies with gastroschisis deliver around 37 weeks and can be delivered either vaginally or through cesarean section. Your baby should be born at a hospital with close access to a high-level neonatal intensive care unit (NICU). CHOC has the only Level 4 NICU in Orange County—the highest level available because of the complex conditions we treat—and we have the only Surgical NICU on the West Coast. Learn more about our NICU.

Your baby will be assessed by a neonatologist and a pediatric surgeon and will need surgery soon after birth. If the gastroschisis is too large to be closed immediately after birth, a covering called a silo is placed over the exposed abdominal organs. Then, the organs are gradually reduced through the silo into the opening and returned to the body in a gradual process that can take up to a week. If the defect is small and the condition of the intestines allows, the gastroschisis will be repaired immediately. Sometimes this can even be done at the bedside in the NICU, using a process called “sutureless closure,” which does not require stitches or general anesthesia.

Babies with gastroschisis can stay in the hospital from two weeks to several months. Because your baby’s intestines have been floating in amniotic fluid for months, they are often swollen and need time to start to function. It can often take several weeks before the intestines are ready to handle milk. Once they are ready, feedings start off in very small amounts, something called “trophic feeds.” Feedings are then gradually increased day by day. Babies are discharged from the hospital when they are taking all their feedings by mouth and are gaining weight, and once intestinal function has returned.

What is the long-term outcome for a baby with gastroschisis?

The prognosis for gastroschisis is good, although there is a range of severity that depends entirely on the condition of the intestine. It is also rare to have other medical conditions associated with gastroschisis, although sometimes bowel blockages (intestinal atresia) and gastroesophageal reflux disease (GERD) can occur.

Overall survival for a baby born with gastroschisis is more than 95 percent. Fortunately, most fetuses with gastroschisis do not have severe damage to the intestine before birth. The relatively normal intestine can be returned to the abdomen and the defect closed in one or two surgical operations shortly after birth. These babies will still be in the NICU for several weeks before the intestines work well enough to allow feeding and subsequent discharge home.

The Only Surgical NICU on the West Coast

baby surgeryWhen it comes to surgery, babies present a unique challenge because of their small size and complex conditions. Their health can change in an instant, requiring quick action and expertise.

No other hospital in the region is prepared to meet this challenge like CHOC Children’s. We proudly offer the only Surgical Neonatal Intensive Care Unit on the West Coast, providing highly specialized care for babies who need surgery.

The Surgical NICU brings every member of the care team together to follow a coordinated plan for babies, and provide a seamless experience for families. This coordinated effort is backed by national-level research and quality improvement efforts, all of which has led to better patient outcomes.

Meet Our CHOC Children's Specialists Surgeons

Awan, Saeed MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Saeed Awan is a board certified pediatric general and thoracic surgeon who treats children and teens at CHOC Children's in Orange County.

Gholizadeh, Maryam MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr Maryam Gholizadeh is a board-certified pediatric surgeon who performs general and thoracic surgeries on infants, kids and teens at CHOC Children's.

Gibbs, David L. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Gibbs serves as director of trauma services at CHOC Children’s and is the CHOC Children’s Specialists division chief of pediatric surgery.

Guner, Yigit S. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Yigit Guner is a board-certified pediatric surgeon who performs general and thoracic surgeries on infants, kids and teens at CHOC Children's.

Kabeer, Mustafa H. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Mustafa Kabeer is a board-certified pediatric surgeon at CHOC Children's. He was the first physician to perform pediatric lung resection in the world.

Reyna, Troy M. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050

Dr. Troy Reyna is a board-certified pediatric surgeon at CHOC Children's, and was one of the first physicians to introduce minimally invasive surgery for children.

Yu, Peter T. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050

Dr. Peter Yu is a board-certified pediatric surgeon who performs general and thoracic surgeries on infants, kids and teens at CHOC Children's.

To schedule a consultation with a CHOC Children’s pediatric surgeon, please call 714-364-4050.

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UC Irvine

CHOC Children's is affiliated with the UC Irvine School of Medicine