Introduction
You are about to become a parent. Your first ultrasound brings about much excitement. However, while in the middle of the ultrasound, the doctor stops, poses a challenge, and shares with you the fact that the fetal abdominal wall was not properly formed, and part of the intestines are extruding from the body.
This condition is known as gastroshiza, commonly referred to as gastroschisis.
Most parents are in a state of shock after hearing this diagnosis. They start questioning what gastroshiza is, how early it is diagnosed, and what the possible treatment options.
In this text, we will explain what gastroshiza is and how it is diagnosed, what treatment options are available, and the possible outcomes for parents after the child has gone through the necessary surgical procedures. We aim to provide you with knowledge, peace of mind, and comfort.
What is gastroshiza?
Adults with gastroshiza represent a very small minority of births. It is a condition where the child is born with abdominal organs and structures, with the intestines lying externally.
This remains an abdominal wall birth defect and it early during the pregnancy, buck the child is between 4 and 8 weeks old. With regards to some congenital problems that can be concealed till birth, gastroshiza, in most cases, is identified before birth thanks to echography.
Such timeliness in identification is important in planning delicate treatments for these patients, which can be provided immediately after delivery.
Gastroshiza is a congenital disorder characterized by defects in stomach wall closure, and it is important to be able to identify it for the preparation it can enable for both delivery and treatment. Below, one can find the most important identification criteria:
1. Pathological Echo Findings
Gastroshiza, as with many congenital disorders, is most frequently identified as a result of routine ultrasounds.
In some cases, one might be able to see an outline of the fetus with exposed organs, and in most of these cases, the tube-like structure called the intestines is found to be outside the fetal abdominal cavity.
This is better observed from the start of the second trimester of pregnancy, that is, 18 to 20 weeks into the pregnancy.
2. Increased concentration of AFP
As a routine practice during pregnancy, blood from the expectant mother is tested, and it is not uncommon to find elevated amounts of AFP protein in the blood plasma.
AFP can be considered as one of the most critical markers that can suggest potential abdominal and gastroshiza wall defects, though indeed a more comprehensive workup is warranted in cases where AFP is of elevated values.
3. Hypotrophy
As with many variations of gastroshiza, the fetus is considered to be proportionate to the average size with the intestinal organs outside the body, and able to breathe oxygen, a gaseous process that is essential for all forms of life.
It is important to note that some of these infants are perceived to be considerably smaller than their counterparts, and this is a result of poor nutrition, which is a result of the intestines. Abnormal Position of Organs
The liver or stomach can, in some instances, protrude out of the abdominal cavity. This can be noted in some later scans if the condition is more advanced.
No Protective Sac
The main difference between gastroshiza and some other conditions is that gastroshiza does not have a protective covering over the organs. This makes the diagnosis quite obvious on ultrasound.
Story Example: Emma’s Diagnosis
When a 26-year-old expectant mother, Emma, went for a 20-week scan, one of the doctors AFP levels and then confirmed with the ultrasound that her baby’s intestines were outside the abdomen.
Although frightened at first, Emma’s doctors told her what the condition was, how they would treat it, and reassured her how incredible the survival rate is incredible. This preparation helped Emma feel more in control when her baby was born.
How Doctors Diagnose Gastroshiza?
Knowing about the condition beforehand can ease the burden on the parents. The primary ways of diagnosing it include:
Prenatal Ultrasound
This is considered the best way to diagnose gastroshiza. Distinct pictures often illustrate the exposed intestines floating in the amniotic fluid.
Maternal Serum Screening
Tests like the quadruple screening can determine if there is an abnormal level of AFP and if an abdominal wall defect is likely.
Fetal MRI (If necessary)
In case an imaging technique needs to be more detailed or more than one anomaly is present, a fetal MRI exam could be suggested.
How Doctors Treat Gastroshiza?
Gastroshiza treatment is meticulous, given the development of plans-
Treatment is done after the child is born.
Steps taken are as follows:
Step 1: Planning the Delivery. Gastroshiza babies are most of the time born through a cesarean delivery. This minimizes the amount of stress placed on the organs that are exposed.
Step 2: The Protection of Organs after Birth. The babies after birth are placed in a sterile silo bag to protect the exposed intestines to prevent infection.
Step 3: Surgical Repair. The definitive method of treatment is through surgery. The two common methods are as follows:
Primary repair: surgeons close the opening in one surgery.
Staged Repair (silo method): If the abdominal cavity is too small, the organs are gradually pushed inside.
Step 4: Recovery and Nutrition Support. After birth, babies are placed in a NICU and are fed through an umbilical catheter.
Survival Rates and Prognosis
With the advancement in medical procedures and treatment the CDC claims that the rate of survival of children with gastroshiza has increased and is at 90%.
The news is that survival rates for children with gastroshiza have increased greatly.
Some infants might still face the following obstacles:
– Deficiencies in feeding.
– Increased time in the hospital.
– Greater chances of infection or bowel blockage.
Pros and Cons of Current Treatments
Pros
– Very high rates of survival.
– Treatments are accessible and immediate.
– Outcomes continuously increase with improvement in neonatal care.
Cons
– There is always a possibility of infection and scarring.
– Severe cases take a longer time to fully recover.
– Lots of mental strain on the family.
How Gastroshiza Affects Families?
The news may be daunting, and the concept of a gastroshiza surgery may appear to be a complex one, but the parents are usually filled with fear and are confused about the entire situation.
This is why with medical attention, gastroshiza parents can feel better. Many parents feel that they can take solace in their stories, which are similar to the stories of other parents.
Future Trends in Treating Gastroshiza
Introduction of suture, which is the most up-to-date method of borderline surgery, may assist in the correction of bowel gastroshiza in utero. Alongside this, surgeries performed in the neonatal period are of greater accuracy and take less time to perform.
Closing the abdominal wall with the herniated bowels is shrouded in mystery, and with refined suture medicine, should soon be simplified.
Conclusion
Gastroshiza, while alarming, does have good news. Early understanding and modern strategies and techniques, as well as treatment with experienced professionals, have shown hope for babies with Gastroshiza.
Most babies survive with good health. Catching the signs of the disorder as well as coming up with a treatment plan ahead of time is crucial, and then collaborating with experienced physicians is of the utmost importance.
While it may be easy for parents to feel defeated at the start of the process, advancements in medicine, coupled with easy accessibility to information and support, have strengthened hope for babies with Gastroshiza.
Frequently Asked Questions (FAQ)
1. What causes gastroshiza?
The complete reason is not clear; however, there are suggestions of the involvement of the young age of the mother, smoking, and certain environmental factors.
2. How early can gastroshiza be detected?
While it can usually be detected during the 18-20 week Ultrasound Period, there can be higher levels of AFP in the blood that can signal indicators of it earlier.
3. Is gastroshiza the same as omphalocele?
Not quite. In an omphalocele, the organs reside in a section of the body, whereas in gastroshiza they are free to be viewed from the body’s exterior.
4. Can gastroshiza be prevented?
Bolstering the argument for gastroshiza not being able to be fully prevented, indeed, is not having protection from smoking, consuming alcohol, and using any illicit substances during a pregnancy.
5. Do all babies with gastroshiza need surgery?
In all cases, babies with gastroshiza are the only ones who can undergo the treatment of the organs being placed in the abdomen.
6. Can babies with gastroshiza live a relatively normal life after recovery?
Though some babies may have some early digestive issues, most of them do well after surgery and lead perfectly healthy lives.
7. How long do babies spend in the hospital after undergoing surgery?
Most babies are likely to spend several weeks in the NICU during which they do not eat and only digest food.
8. Is gastroshiza a genetic disorder?
Most cases of gastroshiza are random and not inherited, which is why this disorder is not well understood, and research is still being conducted.
9. What can parents do after diagnosing them?
Coordinate with a maternal-fetal medicine physician, considering delivery at a hospital with a NICU, and reach out to the facilities and familes support network.
10. What is the gastroshiza survival rate?
With appropriate care, survival rates are more than 90 percent, but illness severity and general health strongly influence the prognosis.