Gastroshiza: A Complete Guide to Causes, Symptoms, and Treatment

Gastroshiza is a rare congenital condition where a baby is born with some of their intestines protruding outside the abdominal cavity through a small opening near the belly button. Unlike some similar conditions, the exposed intestines are not covered by a protective sac, leaving them vulnerable to injury and infection. Modern medical advancements have greatly improved treatment success rates, but awareness remains essential for parents and healthcare providers alike.

What is Gastroshiza?

Gastroshiza develops during the early stages of pregnancy when the abdominal wall fails to form completely. The defect typically appears to the right of the umbilical cord, creating an opening through which the intestines—and in some cases other organs—extend outside the baby’s body. Since there is no protective covering, amniotic fluid can irritate the exposed intestines, sometimes causing inflammation or swelling before birth.

How Common is Gastroshiza?

Although gastroshiza is considered rare, medical studies suggest its occurrence is rising in many parts of the world. It is estimated to affect 1 in every 2,000 to 4,000 live births. The condition is more frequently seen in younger mothers, particularly those under 20 years old.

Causes and Risk Factors of Gastroshiza

The exact cause of gastroshiza is not fully understood, but researchers believe it results from a combination of environmental and developmental factors. Key risk factors may include:

• Young maternal age (especially teenage pregnancies)

• Smoking or alcohol consumption during pregnancy

• Poor prenatal nutrition, especially low folic acid intake

• Exposure to certain chemicals or medications during early pregnancy

• Circulatory issues that affect fetal development of the abdominal wall

It’s important to note that gastroshiza usually occurs randomly and is not inherited in most cases.

Signs and Symptoms of Gastroshiza

The main symptom of gastroshiza is visible at birth: the baby’s intestines protrude outside the body through an opening in the abdominal wall. However, the condition is often diagnosed during pregnancy. Common signs include:

• Abnormal prenatal ultrasound results showing intestines outside the abdomen

• Elevated alpha-fetoprotein (AFP) levels in the mother’s blood

• Possible twisting or damage to the intestines due to prolonged exposure to amniotic fluid

Diagnosis of Gastroshiza Before Birth

Early detection of gastroshiza is crucial for planning a safe delivery and immediate medical intervention. Common diagnostic steps include:

1. Prenatal Ultrasound – Detects the defect as early as the 12th week of pregnancy.

2. Maternal Blood Testing – Identifies high AFP levels, which may indicate an abdominal wall defect.

3. Fetal Echocardiogram – Screens for any additional birth defects.

With a confirmed diagnosis, doctors can prepare for delivery in a facility with specialized neonatal surgery teams.

Treatment of Gastroshiza

Treatment for gastroshiza involves surgery to place the intestines back into the abdominal cavity and close the opening. The approach depends on the severity of the defect.

1. Primary Closure Surgery

If the defect is small and the intestines are healthy, the surgeon may return them to the abdominal cavity in one operation immediately after birth.

2. Staged Closure

If swelling or large protrusion prevents immediate closure, a protective pouch (silo) is placed over the intestines. Over several days, the intestines are gradually guided back inside before closing the abdominal wall.

Post-Surgical Care and Recovery

After surgery, babies with gastroshiza require care in a neonatal intensive care unit (NICU). Post-treatment care includes:

• Intravenous feeding until the intestines function normally

• Antibiotic therapy to prevent infection

• Gradual introduction of oral feeding

• Monitoring for complications such as bowel obstruction or feeding difficulties

Most infants recover fully, though they may need follow-up for digestive or growth concerns.

Possible Complications of Gastroshiza

While treatment success rates are high, possible complications can include:

• Infections due to exposed intestines before surgery

• Intestinal blockages from scar tissue

• Feeding challenges during infancy

• Slower weight gain in the first year of life

Living with Gastroshiza: Parental Guidance

A diagnosis of gastroshiza can be emotionally challenging for parents. Emotional support, counseling, and connecting with other families who have gone through similar experiences can be invaluable. Many hospitals provide parent education programs to prepare families for the baby’s surgery and recovery.

Can Gastroshiza Be Prevented?

While there is no guaranteed way to prevent gastroshiza, certain healthy habits may reduce risks:

• Start prenatal care early in pregnancy

• Avoid alcohol, smoking, and recreational drugs

• Eat a nutrient-rich diet with adequate folic acid

• Limit exposure to harmful chemicals

• Follow medical advice for safe medication use during pregnancy

Conclusion

Gastroshiza is a serious but treatable birth defect. Thanks to medical advancements, most babies born with this condition can recover and lead healthy lives. Early diagnosis, proper prenatal care, and timely surgical intervention are key to positive outcomes. For expectant parents, awareness and preparation can make a significant difference in the journey from diagnosis to recovery.