Gastroschisis

Our long experience with prenatal diagnosis and planning for optimum care allows us to offer the highest quality treatment whether intervention is indicated before or after birth.

Under the direction of Dr. Michael Harrison, the Fetal Treatment Center was the first institution to develop fetal surgery techniques. The first open fetal surgery in the world was performed at UCSF since the early 1980's. We presently have more experience with fetal surgery and endoscopic fetal intervention (FETENDO fetal surgery) than any other institution in the world. We are dedicated to gastroschisis research and treatment innovation.

What is gastroschisis?

Gastroschisis is an abdominal wall defect like omphalocele in which the anterior abdomen does not close properly allowing the intestines to protrude outside the fetus. The majority of fetuses with this problem are born to mothers in their late teens or early twenties. For some unknown reason, while the fetus is developing, the muscles of the abdominal wall do not form correctly. This allows some of the organs (usually intestine) to protrude outside the fetus's body. The organs outside of the fetus's body are floating in the amniotic fluid.

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What is the outcome for a fetus with gastroschisis?

There is a range of severity for fetuses with gastroschisis that depends entirely on the condition of the intestine. 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 intensive care nursery for several weeks before the intestines work well enough to allow feeding and subsequent discharge home. However, these babies eventually feed normally and grow up normally .

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How serious is my fetus’s gastroschisis?

In order to determine the severity of your fetus's condition it is important to gather information from a variety of tests and determine if there are any additional problems. These tests along with expert guidance are important for you to make the best decision about the proper treatment.

This includes:

1. The type of defect—distinguishing it from other similar appearing problems.
2. The severity of the defect—is your fetus’s defect mild or severe.
3. Associated defects—is there another problem or a cluster of problems (syndrome).

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What are my choices during this pregnancy?

It is important to carefully monitor throughout your pregnancy. Additional tests, other than ultrasounds, are not usually recommended, as this is a condition that is not associated with any other birth defect. Rarely, babies can also have bowel obstruction (blockage) as a consequence of the gastroschisis.

Babies with gastroschisis are watched carefully by ultrasound for intrauterine growth retardation (not growing enough while in the womb) and for damage to the intestines. Damage to the intestine can be caused from exposure to the amniotic fluid or by impairment of the blood flow to the exposed intestine.

Fetal Treatment

Close ultrasound monitoring is very important during pregnancy. Although fetal surgery (returning the bowel to the abdomen before birth) is not performed, ultrasound findings can determine the timeing of delivery. Signs of bowel obstruction (dilated, swollen bowel), loss of bowel flow, or poor growth of fetus may be indications for early delivery

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What will happen after birth?

Your baby should be born at a hospital with an Intensive Care Nursery and a pediatric surgeon available. Soon after birth, your child will have surgery to close the opening in the abdominal wall and return the organs to the abdomen.

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