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Gastroschisis

Gastroschisis is a congenital (present at birth) intestinal defect.

What it is

Gastroschisis is evidenced by a hole in the baby’s abdominal wall that the intestines stick out of. This condition is caused by a defect on one side of the umbilical cord. It looks similar to an omphalocele, except that it is usually smaller and organs are not covered by a membrane. Gastroschisis exposes the baby’s intestines to amniotic fluid before birth, which increases the risk for complications including bowel dilation, decreased fetal growth and amniotic fluid volume, preterm delivery, and, rarely, fetal death. The condition is usually diagnosed through an ultrasound before birth.

Symptoms

  • Lump in the abdomen
  • Intestines sticking out of the abdominal wall near the umbilical cord

Causes

Painkillers: Exposure to opioid painkillers before birth can nearly double a baby’s likelihood of developing gastroschisis, according to research conducted by the Centers for Disease Control and Prevention (CDC). Opioid painkillers include:

  • Codeine
  • Hydrocodone
  • Oxycodone

Anti-depressants: Babies whose mothers take certain SSRI anti-depressants during pregnancy are 30% more likely to develop gastroschisis, according to an article published in the New England Journal of Medicine. SSRI anti-depressants include:

  • Paxil
  • Zoloft
  • Prozac
  • Lexapro
  • Celexa

Treatment

Close surveillance of a baby with gastroschisis is important in the third trimester to monitor the complications that can arise from the birth defect. After birth, gastroschisis can be repaired through a surgery during which the exposed bowels are returned to the abdominal cavity and the abdominal wall is closed. There are a couple options, including a single operation or a staged repair. The staged repair is often used when the abdominal cavity is too small to hold all the intestines. A protective mesh sack is stitched over the exposed organs and over time, they fall back into the abdominal cavity.

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