Gastroschisis: Causes, Symptoms, and Treatment

Medically Reviewed by Jabeen Begum, MD on April 09, 2024
Written by Lori M. King, PhD
7 min read

Gastroschisis (pronounced ga-straa-skuh-suhs) is a rare condition where your baby develops with a hole in their belly on one side of their belly button. Their intestines, and sometimes other organs, such as their stomach and liver, grow through this hole on the outside of their body.

It generally happens early in development when the muscles in your baby’s belly don’t form correctly. This leaves an opening through which their internal organs grow and develop.

Babies with gastroschisis will need an operation soon after they are born and may need to stay in the hospital for some time. While this condition can be especially scary for parents, babies often do fine once the condition is fixed.

Gastroschisis and omphalocele (pronounced aam-fuh-luh-seel) are both rare conditions a baby can be born with. In both cases, your baby develops with a hole in their belly wall that allows their intestines, and possibly other organs, to develop outside their body. They differ in where the hole develops. In gastroschisis, the hole is next to their belly button, but in omphalocele, the hole is in their belly button.

Also, in omphalocele, their organs are covered by a membrane, but the membrane may break open while the baby is still inside you or during birth. In gastroschisis, their organs aren't covered by a membrane. Since their intestines aren't covered, they can become inflamed due to direct exposure to your amniotic fluid. This inflammation may irritate their intestines, which can cause problems after they're born, such as scar tissue or intestinal obstruction.

Your obstetrician can usually diagnose gastroschisis or omphalocele during one of your regular prenatal ultrasounds.

You will likely not be able to feel any symptoms during your pregnancy. However, your doctor may be able to see evidence of gastroschisis in your baby using ultrasound. Such signs include:

  • Low body temperature (hypothermia)
  • Twisted intestines
  • Swollen intestines
  • Stomach and intestines outside your baby's body

Gastroschisis happens when your baby's belly wall doesn't form completely during their development.

There are many potential causes of this. But some cases have no clear cause. Rather than a single cause, it's likely the result of a combination of things, such as:

  • Changes in your baby’s genes or chromosomes
  • Low blood flow to your baby's digestive system
  • Younger age during pregnancy (especially if you're a teenager)
  • Medicines or drugs you take during your pregnancy
  • Foods or drinks (especially alcohol) you have during your pregnancy
  • Smoking while you're pregnant (especially early in your pregnancy)
  • Having a genitourinary infection (such as a urinary tract infection) within 3 months before or after you get pregnant
  • Having a low body mass index (BMI) during your pregnancy

However, even though doctors have some clues about what may cause gastroschisis, it's still rare. CDC estimates that about one out of every 1,953 babies are born in the U.S. with gastroschisis. It seems to have become more common over time, especially in babies born to younger people. 

 

Your obstetrician may diagnose your baby while you're still pregnant, usually when you're between 18 and 20 weeks, during one of your regular prenatal screening tests, such as:

Maternal blood screening (also called quad screen). This test is usually done between 15 and 22 weeks of pregnancy. It measures four things in your blood. One of those is a protein called alpha-fetoprotein (AFP). If you have higher than normal levels of this, your baby may have gastroschisis, but your doctor will do further tests to confirm.

Ultrasound. An ultrasound uses sound waves to map a picture of your baby. It may show your baby's organs floating outside of their belly.

Fetal echocardiogram (also called fetal echo). This is another ultrasound that specifically shows your baby's heart. Some babies with gastroschisis also have heart problems. This test will allow your doctor to monitor how your baby's heart is developing.

MRI. This uses a large magnet and radio waves to map a picture of your baby. Like ultrasound, it may show your baby's organs floating outside of their belly.

If your baby has gastroschisis, you’ll need extra attention while you are pregnant. You will need a plan for managing the rest of your pregnancy and the birth. You may be referred to a few specialists including a: 

  • Maternal-fetal medicine specialist
  • Neonatologist, a specialist who cares for newborn babies, especially those that are sick or premature
  • Pediatrician
  • Pediatric gastroenterologist, a specialist who treats digestive problems in babies and kids
  • Pediatric surgeon because your baby will need surgery soon after birth

Your doctors will continue to monitor your pregnancy and baby with ultrasound and other tests, such as:

Ultrasound. Babies with gastroschisis tend to be smaller than others. You may need monthly or even more frequent ultrasounds to monitor your baby's development.

Fetal movement counting. Your doctor may ask you to do this starting around 26 weeks. They will have you count your baby's movements for about 2 hours every day. At this point in their development, healthy babies generally move a minimum of 10 times in a 2-hour period.

Nonstress tests and biophysical profiles. Your doctor may have you do nonstress tests and biophysical profiles around 32 weeks. A biophysical profile is the combination of your non-stress test and an ultrasound.

 

Babies with gastroschisis may have the following problems:

  • Twisting and swelling of their intestines
  • Low birth weight
  • Trouble nursing and eating
  • Difficulty digesting their food and absorbing nutrients
  • Stillbirth (rare)

Your doctor may induce (bring on) labor between 35 and 37 weeks, which is a bit earlier than the normal 40 weeks. Having a baby with gastroschisis doesn’t necessarily mean you need a C-section (an operation in which the baby is removed through an incision in your lower belly). But you should plan to deliver at a hospital with an intensive care nursery. That’s because your baby will need surgery soon after birth.

Your baby will need surgery after birth to put their organs back inside them and seal the hole. There are two main surgeries doctors use to do this. Which one your doctor recommends will depend on how many organs they have outside their body and how severely their intestines are inflamed. The two surgery options are:

Primary gastroschisis repair. This is usually done on babies whose condition is not very severe, and it's done immediately after birth. Your surgeon will put any organs back inside the baby’s belly and then repair the opening.

Staged gastroschisis repair. This is usually for more serious cases. After the baby is born, their organs are carefully covered in a plastic bag called a silo. This helps protect them, prevent infection, and keeps them moist. Over several days, their organs are slowly pushed back inside their body. After everything is back in, your surgeon repairs the hole in their belly.

After surgery, your baby may need help to breathe because of the added pressure from the organs that are now back inside their body. Your baby may need to be fed through an IV for a while because their digestive system may take some time to heal and start working. So, they may need to stay in the hospital for weeks, or sometimes longer.

With gastroschisis, your baby's organs aren’t protected from your amniotic fluid like they would be if they were inside their body. Amniotic fluid is the liquid that surrounds the baby. Exposure to amniotic fluid can cause inflammation in their organs. Because of the inflammation, some babies born with gastroschisis develop digestive problems, such as:

  • Breathing problems and heart problems immediately after birth
  • Intestinal atresia, which is a blockage in their intestines
  • Intestinal perforation, which is a hole in their intestines
  • Volvulus, which is a twisting of the intestines that may cause their blood supply to be cut off
  • Infarction, which is damage to the tissue because the blood supply has been cut off

Gastroschisis surgery may cause the following complications:

  • Infection where your baby had surgery
  • Trouble nursing or eating
  • Need for additional surgery to remove segments of damaged intestines, such as a colostomy (where a section of their intestines is passed through an opening in their belly so that poop can pass into a bag attached to their belly)

You may be able to reduce your risk of having a baby with gastroschisis if you:

  • Avoid smoking or using other tobacco products while you're pregnant
  • Avoid alcohol while you're pregnant
  • Avoid opioid painkillers while you're pregnant
  • Eat a nutritious and balanced diet

Gastroschisis is a condition where your baby develops with a hole in their belly through which their intestines, and sometimes other organs such as their stomach and liver, grow on the outside of their body. Your obstetrician will usually diagnose your baby during one of your routine prenatal screening tests. You can help prevent gastroschisis in your baby by avoiding tobacco, alcohol, and opiates during your pregnancy and eating a healthy, balanced diet. If your baby does develop gastroschisis, they will need surgery soon after birth to return their organs to their belly and repair the hole.

Can a baby survive gastroschisis?

Yes, babies can and do survive gastroschisis. Thanks to advances in newborn care and surgery, most (about 95%) babies with gastroschisis survive. If gastroschisis is their only health condition, they will mostly likely recover fully and develop normally.

What is the life expectancy of gastroschisis?

Most babies recover well from repair surgery and go on to live a normal life span.