Understanding Gastroshiza: Causes, Symptoms & Treatment

Gastroschisis is a congenital birth defect where a baby’s intestines extend outside the body through an opening beside the belly button. It affects 1 in 2,400 babies in the U.S. and requires surgical repair shortly after birth, with over 90% survival rates when treated promptly.

You just received unexpected news during your pregnancy ultrasound. Your doctor mentioned gastroschisis, or what some call “gastroshiza.” Your mind races with questions: What does this mean for your baby? How serious is it? What happens next?

This guide answers those questions with current medical facts, treatment options, and realistic outcomes. You’ll learn what gastroschisis is, why it happens, and what to expect from diagnosis through recovery.

What Is Gastroschisis?

Gastroschisis (pronounced gas-troh-skee-sis) is a birth defect where a baby’s intestines protrude outside the body through a small opening in the abdominal wall. This opening typically appears to the right of the belly button and measures between 2 to 5 centimeters.

Unlike omphalocele (a similar condition), gastroschisis leaves the intestines unprotected by a membrane. The exposed organs float in amniotic fluid throughout pregnancy, which can cause irritation and swelling.

The condition develops early in pregnancy, around weeks 4 to 6, when the abdominal wall forms. Doctors usually detect it during routine ultrasounds between 12 and 20 weeks of gestation.

Note on terminology: You may see “gastroshiza” in search results. This is a variant spelling of gastroschisis, the proper medical term used by healthcare providers worldwide.

How Common Is This Birth Defect?

Current data show that gastroschisis affects approximately 1 in 2,400 live births in the United States. From 2016 to 2022, three major national databases documented a declining trend in prevalence, dropping from 3.32 to 2.46 per 10,000 births.

Globally, rates vary by region. North America reports 4.32 per 10,000 births, Latin America shows 3.80 per 10,000, and Europe reports 1.49 per 10,000 births. South America has historically recorded the highest rates worldwide, at approximately 1 in 1,063 births.

After decades of increasing prevalence, researchers now observe declining rates across multiple countries. The reasons remain under investigation, though factors like reduced teen pregnancies and environmental changes during the COVID-19 pandemic may contribute.

Known Risk Factors and Causes

Scientists don’t fully understand why gastroschisis occurs, but research identifies several risk factors:

Maternal age stands out as the strongest predictor. Women under 20 years old face 11.45 cases per 10,000 births compared to 5.35 per 10,000 for women aged 20 to 24. The risk decreases significantly after age 25.

Other documented risk factors include:

• Smoking during pregnancy
• Low maternal body mass index (BMI under 18.5)
• Genitourinary infections during early pregnancy
• First-time pregnancy (primiparous mothers)
• Young paternal age (independent of maternal age)

Environmental exposure theories suggest connections to certain chemicals and pesticides, though conclusive evidence remains limited. Genetic factors appear less significant than environmental ones, with only 23% of studied families showing multiple relatives with the condition.

Importantly, gastroschisis is not hereditary in the traditional sense. Having one child with gastroschisis doesn’t substantially increase your risk in future pregnancies.

Recognizing Gastroschisis: Diagnosis Methods

Most cases are detected before birth through prenatal care:

Prenatal ultrasound (weeks 12-20) reveals free-floating bowel loops in the amniotic cavity. Sonographers look for intestines outside the abdominal wall without a protective membrane.

Maternal serum alpha-fetoprotein (AFP) levels appear elevated in pregnancies affected by gastroschisis. This blood test often prompts further investigation through a detailed ultrasound.

Physical examination at birth confirms the diagnosis immediately. The visible intestines and characteristic opening beside the umbilical cord make gastroschisis unmistakable.

After diagnosis, doctors classify the condition as either simple or complex:

Simple gastroschisis involves only the intestines outside the body with minimal damage or inflammation. About 75% of cases fall into this category.

Complex gastroschisis includes intestinal complications like atresia (blockage), stenosis (narrowing), volvulus (twisting), perforation, or tissue death. These cases require more extensive treatment.

Treatment Options: Surgical Repair

All babies with gastroschisis require surgery after birth. The timing and approach depend on severity.

Primary repair happens when only a small amount of intestine protrudes and shows minimal swelling. Surgeons perform this procedure on the day of birth. They gently return the organs to the abdomen and close the opening with sutures. This approach works for about 60% of cases.

Staged repair becomes necessary when many organs sit outside the body or severe inflammation exists. Surgeons place the exposed organs in a clear plastic pouch called a silo. Over 7 to 10 days, they gradually push the intestines back inside. Once everything returns to the abdominal cavity, they remove the silo and close the opening.

A newer technique called sutureless closure uses the umbilical cord to cover the defect after reducing the bowel. An adhesive dressing holds everything in place. This bedside procedure avoids general anesthesia and reduces time on ventilators.

Surgery addresses the immediate problem, but recovery takes time. The intestines need weeks to resume normal function. During this period, babies receive:

• Nutrition through an IV (total parenteral nutrition)
• Antibiotics to prevent infection
• Pain management medication
• Nasogastric tube to drain the stomach
• Temperature regulation in the NICU

Most babies can’t eat by mouth for several weeks after surgery. When intestinal function returns, doctors slowly introduce feedings, starting with breast milk through a nasogastric tube.

Expected Recovery and Hospital Stay

Hospital length varies widely based on case complexity. Simple gastroschisis typically requires 2 to 4 weeks in the NICU. Complex cases may extend to 6 to 12 weeks or longer.

The recovery timeline follows a general pattern:

Days 1-3: Surgery and immediate post-operative care. Babies need ventilator support if the abdomen is small and organs create pressure on the diaphragm.

Weeks 1-3: Intestines recover function. Doctors watch for the first bowel movement and signs of normal digestion. IV nutrition continues.

Weeks 3-6: Gradual introduction of oral feedings. Breast milk is preferred because it’s easier to digest. Many babies need fortified formula to meet caloric needs.

Weeks 6+: Most babies can maintain adequate nutrition by mouth and demonstrate steady weight gain. This marks the typical time for hospital discharge.

After going home, babies need follow-up appointments with pediatric surgeons and gastroenterologists. Monitoring continues through the first year to track growth and identify any digestive issues.

Long-Term Outcomes and Survival Rates

Survival rates exceed 90% when babies receive prompt, specialized care at hospitals with experienced NICU teams and pediatric surgeons. Factors that improve outcomes include:

• Delivery at a hospital with Level III NICU capabilities
• Immediate surgical intervention
• Simple (non-complex) gastroschisis
• Full-term or near-term delivery
• Absence of other birth defects

Most children with simple gastroschisis grow and develop normally. They attend regular schools, participate in sports, and face no dietary restrictions.

Some children experience long-term challenges:

Feeding difficulties affect 10 to 15% of children, particularly those with complex gastroschisis. They may show slow weight gain or need specialized nutrition plans.

Intestinal motility issues can cause constipation or require medications to regulate bowel movements.

Small bowel syndrome occurs rarely in severe cases where a significant intestine was lost or damaged. These children need long-term parenteral nutrition support.

Abdominal wall hernias may develop at the repair site, requiring additional surgery later in childhood.

Regular medical follow-up catches and addresses these issues early.

Gastroschisis vs. Omphalocele: Key Differences

Parents often confuse these two abdominal wall defects. Understanding the differences matters for treatment and prognosis:

Gastroschisis generally carries a better prognosis because it rarely occurs with other major birth defects or genetic syndromes.

What Happens During Pregnancy?

After diagnosis, your prenatal care intensifies. Expect more frequent ultrasounds to monitor:

• Intestinal dilation (swelling)
• Bowel wall thickness
• Amount of exposed organs
• Fetal growth patterns

Your maternal-fetal medicine specialist determines the best delivery timing. Most babies with gastroschisis are delivered between 36 and 37 weeks, balancing lung maturity against intestinal damage risk.

You don’t automatically need a cesarean section. About 40% of maternal-fetal medicine specialists allow vaginal delivery unless obstetric complications arise. The key is delivering at a hospital with immediate access to:

• Neonatal intensive care unit
• Pediatric surgeons
• Specialized equipment for temperature regulation and IV nutrition

Some centers recommend delivery slightly earlier if ultrasounds show worsening intestinal dilation or restricted fetal growth. Your medical team weighs these factors individually.

Supporting Your Family Through This Journey

A gastroschisis diagnosis brings emotional challenges. Fear, anxiety, and uncertainty are normal responses. These strategies help families cope:

Connect with other parents who’ve experienced gastroschisis. Support groups (online and in-person) provide practical advice and emotional understanding that friends without this experience can’t offer.

Ask questions without hesitation. Your medical team expects questions. Write them down before appointments so you don’t forget important concerns.

Focus on what you can control: Following prenatal care recommendations, preparing your home for a NICU stay, and learning about infant care after surgery.

Accept help from family and friends. Long NICU stays are exhausting. Let others bring meals, handle household tasks, or provide childcare for siblings.

Take care of your mental health. Some parents benefit from counseling. NICU social workers can connect you with resources.

Remember that this condition is temporary. The vast majority of children with gastroschisis go on to live completely normal, healthy lives.

FAQs

Can gastroschisis be prevented?

No known prevention methods exist since the exact cause remains unclear. However, maintaining good prenatal care, avoiding smoking, and treating infections early may reduce risk.

Will my baby need multiple surgeries?

Most babies (75-80%) need only one surgery. Complex cases may require additional procedures to address intestinal blockages or hernias.

How long will my baby stay in the hospital?

Average stays range from 2 to 6 weeks for simple cases, longer for complex gastroschisis. Each baby’s timeline differs based on when intestinal function returns.

Can my baby breastfeed?

Yes, eventually. Breast milk is highly recommended and easier to digest. Initially, babies receive pumped breast milk through feeding tubes, transitioning to direct breastfeeding as they recover.

What follow-up care does my child need?

Regular appointments with a pediatric surgeon continue through age 1, sometimes longer. Gastroenterology follow-up monitors growth, nutrition, and digestive health.