Pediatric Surgery Specialist Prof. Dr. Feryal Gün Soysal explained what you need to know about gastroschisis seen in newborns.
Gastroschisis is a birth defect that develops in the baby during pregnancy. This condition occurs when an opening forms in the baby's abdominal wall. The baby's intestine enters through this hole. The intestine then develops outside the baby's body in the amniotic fluid.
The opening is mostly on the right side of the baby's belly button. It can be large or small, but is typically 2 to 5 cm in size. In more severe cases, the stomach and/or liver can sometimes pass through the opening.
The intestine is unprotected because it is outside the baby's body. This means there is a chance of irritation, swelling and damage.
This condition is relatively rare but has seen an increase in recent years. It is seen in one in every 2,000 babies. It develops in early pregnancy, around the fourth to eighth weeks. Gastroschisis occurs due to weakness in the abdominal wall muscles near the baby's umbilical cord. If your baby develops this condition during your pregnancy, you will not experience any symptoms related to it.
Gastroschisis can be repaired with surgery after your baby is born. It is usually not associated with other malformations.
What causes gastroschisis?
The exact cause of gastroschisis is unknown. It does not appear to be hereditary. Having a baby with gastroschisis does not increase your chances of having another baby with this condition.
Gastroschisis can be described as simple or complex. This depends on how inflamed the intestine and/or organs passing through the opening are.
The intestine outside the baby's body may be extremely damaged, for example, some of the tissue may have died (called necrosis), or the intestine may be twisted or tangled. Intestinal atresia can occur when part of the baby's intestine is not fully formed or the intestine becomes blocked. Other organs, such as the stomach or liver, may also protrude through the opening.
How is its diagnosis and treatment?
It is possible to detect gastroschisis in the third month of pregnancy. However, once revealed on ultrasound, it is usually worth 20-24 weeks. assessment is made. It is usually around the 18-20th week of pregnancy. It is diagnosed by ultrasound in weeks. It is important to diagnose and make a birth plan as early as possible.
There are no recommended fetal interventions for babies with gastroschisis. The situation cannot be corrected while you are pregnant. Rather, your baby should be treated immediately after birth. Every baby with gastroschisis needs surgery after birth. The baby cannot survive with its intestine outside the body.
After your baby is born, it is evaluated how severe gastroschisis is. The type of treatment needed depends on how much intestine and/or organs your baby has outside of his or her belly and any inflammation or damage to those tissues.
Treatment with a simple case of gastroschisis is often referred to as "primary repair." This is a surgery in which the intestine is placed back inside the baby's abdomen and the abdominal opening is closed. If possible, this surgery is performed on the day your baby is born.
This type of repair is performed when there is a relatively small amount of intestine outside the belly and the intestine is not overly swollen or damaged.
In some cases, primary repair may not be possible. For example, if the baby has a large amount of intestine outside the body, if the intestine is very swollen, if there is not enough room in the baby's abdomen to hold the entire intestine, surgery may be needed to gently replace the intestine/organs inside the abdomen. This is called "progressive repair". This occurs within a few days and can take up to two weeks.
With a gradual repair, a plastic bag or "silo" is placed around the intestine and attached to the belly. Each day the silo is compressed and some of the intestines are gently pushed inside. Once the entire intestine is inside, the silo is removed and the umbilicus is closed.
Post-operative care
Your baby's intestine has developed outside the abdomen. It needs to heal and adjust to function normally. Therefore, babies with gastroschisis often experience feeding difficulties in the first few weeks of life.
During this time, your baby may be given medication supplements for relief. Once your baby's intestines are functioning, usually after about two to three weeks, breast milk or special formula can be introduced. While your baby is feeding and It is discharged when the intestine functions normally.
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