Gastroschisis is a birth defect where a baby’s intestines protrude through a hole in the abdominal wall, typically to the right of the belly button. This condition affects approximately 1 in 4,000 births and requires surgical repair shortly after delivery. With modern medical care, survival rates exceed 90%, though babies may need extended hospital stays for recovery.
Receiving a gastroschisis diagnosis during pregnancy can feel overwhelming. You’re facing medical terms you’ve never heard, wondering what caused this, and trying to understand what comes next for your baby.
This guide breaks down everything you need to know about gastroschisis—from why it happens to what treatment looks like and what life holds after surgery.
What Is Gastroschisis?
Gastroschisis occurs when your baby’s abdominal wall doesn’t form completely during early pregnancy. A hole develops beside the umbilical cord (usually on the right side), allowing intestines and sometimes other organs to float freely in the amniotic fluid.
Unlike an omphalocele (another abdominal wall defect), no protective membrane covers the exposed organs. This direct contact with amniotic fluid can irritate and damage the intestines before birth.
The defect typically measures 1-2 inches across. Besides the intestines, the stomach, liver, or bladder may also protrude through this opening.
Who’s at Risk?
Young mothers face the highest risk. Women under 20 years old are seven times more likely to have a baby with gastroschisis compared to mothers aged 25-29.
Research identifies several risk factors:
Maternal Age and Lifestyle
- Teen pregnancies show significantly elevated rates
- First-time mothers (nulliparous) face an increased risk
- Low or normal pre-pregnancy body weight (BMI under 18.5)
Substance Exposure
- Cigarette smoking during early pregnancy
- Alcohol consumption before or during pregnancy
- Recreational drug use, particularly vasoconstrictive substances
- Over-the-counter medications like aspirin or ibuprofen
Infections
- Genitourinary infections during the first trimester
- Urinary tract infections before conception
Environmental Factors
- Exposure to certain chemicals (nitrosamines, atrazine)
- Low socioeconomic status
Obesity appears to offer some protective effect, though researchers don’t fully understand why.
Recent data from 2014-2022 shows gastroschisis rates declining in the United States, from 2.86 per 10,000 births to 1.55 per 10,000. This drop correlates with fewer teen pregnancies rather than COVID-19 impacts or other factors.
How Doctors Diagnose Gastroschisis
Most diagnoses happen during routine prenatal care.
Second Trimester Screening: Your 20-week anatomy ultrasound typically reveals gastroschisis when imaging shows free-floating bowel loops outside your baby’s body. The technician can identify the defect location and which organs are affected.
Blood Tests Elevated maternal serum alpha-fetoprotein (AFP) levels often indicate an abdominal wall defect. Your doctor orders this test between weeks 15-20 of pregnancy.
Ongoing Monitoring Once diagnosed, you’ll need ultrasounds every 3-4 weeks starting at 24 weeks. These appointments track:
- Fetal growth patterns
- Bowel appearance and thickness
- Amniotic fluid levels
- Organ exposure changes
Growth restriction affects 24-67% of babies with gastroschisis. Doctors monitor this closely because poor fetal growth can signal complications.
Simple vs. Complex Gastroschisis
Medical teams classify gastroschisis into two categories that determine your baby’s outlook:
Simple Gastroschisis (75% of cases). The intestines look relatively normal at birth. No major intestinal complications exist beyond the wall defect itself. Recovery tends to be straightforward with fewer interventions needed.
Complex Gastroschisis (25% of cases). Additional intestinal problems appear at birth:
- Intestinal atresia (blocked or disconnected sections)
- Bowel perforation or necrosis
- Volvulus (twisted intestines)
- Severe bowel damage
Babies with complex gastroschisis face longer hospital stays, require more surgeries, and experience higher rates of complications like short bowel syndrome.
Pregnancy Management and Delivery
Where you deliver matters.
Your medical team should include:
- Maternal-fetal medicine specialist
- Neonatologist
- Pediatric surgeon
- NICU with level III or IV capabilities
Timing Delivery Most spontaneous deliveries occur around 36-38 weeks. Recent guidelines from the University of California Fetal Care Consortium recommend:
- Delivery at 38 weeks for uncomplicated cases
- Delivery at 37 weeks if growth restriction appears
- Earlier delivery only if fetal distress develops
Delivery Method: Vaginal delivery is safe and recommended for most gastroschisis cases. Cesarean section is only necessary for standard obstetric reasons or if significant liver herniation occurs.
Delivering at a facility equipped for immediate neonatal surgery eliminates dangerous transport time for your newborn.
Surgical Treatment Options
Surgery happens within hours or days of birth.
Immediate Care at Delivery: Your baby’s exposed organs get placed in a sterile plastic bag (bowel bag) covering the lower body. This protects organs while allowing doctors to monitor blood flow.
Medical staff insert an orogastric tube to decompress the stomach and establish IV access for fluids and antibiotics.
Primary Closure. When the defect is small and the organs are relatively healthy, surgeons can perform closure right away. They gently return organs to the abdomen and stitch the opening closed. This single procedure offers the fastest recovery path.
Staged Reduction (Silo Method): Larger defects or swollen organs require gradual reduction. Surgeons place a spring-loaded silo—a temporary plastic pouch—over the exposed organs. Gravity slowly moves organs back inside over 3-10 days.
Once all organs return to the abdominal cavity, surgeons remove the silo and close the opening.
Sutureless Closure. Some facilities offer bedside closure without general anesthesia. Recent studies show this approach reduces ventilator time, antibiotic use, and surgical site infections compared to traditional sutured repair.
Monitoring for Complications Surgeons carefully watch abdominal pressure during closure. Pressure above 15-20 mmHg can compromise blood flow to organs, risking abdominal compartment syndrome.
Hospital Recovery
Your baby will spend time in the NICU—anywhere from two weeks to several months, depending on complications.
Feeding Challenges: Intestines exposed to amniotic fluid need time to recover function. Most babies can’t tolerate regular feeds for several weeks after surgery.
Your baby receives nutrition through an IV (total parenteral nutrition or TPN) until their digestive system works properly. The transition to breast milk or formula happens gradually as bowel function returns.
Common Complications During Recovery
- Necrotizing enterocolitis (NEC): Affects up to one-third of babies
- Line sepsis from IV access
- Surgical site infections
- Difficulty breathing requiring ventilator support
- Temperature regulation issues
Babies with simple gastroschisis typically achieve full oral feeding faster and go home sooner than those with complex cases.
Long-Term Outlook and Follow-Up Care
Survival rates for gastroschisis exceed 90% in well-equipped medical centers. But what happens after your baby comes home?
Common Long-Term Issues
- Abdominal pain: 41% of children experience weekly pain; 30% require hospitalization
- Growth patterns: Most children show catch-up growth by school age, though complex cases may remain smaller
- Additional surgeries: 54% need at least one more operation (hernia repairs being most common)
- Feeding difficulties: Reflux, slow gastric emptying, and malabsorption improve with time
Serious Complications (Less Common)
- Short bowel syndrome requiring prolonged TPN
- Intestinal blockages from adhesions
- Multiple organ transplantation needs
- Intestinal failure requiring transplant
Development and Quality of Life Research shows that most children with simple gastroschisis achieve normal developmental milestones. Cognitive function, learning abilities, and overall health-related quality of life typically fall within normal ranges.
Children with complex gastroschisis may face:
- Delayed motor skills from extended hospitalization
- Nutritional deficiencies
- Lower weight and BMI compared to peers
Physical therapy, occupational therapy, and nutritional support address these challenges.
Cosmetic Concerns: Abdominal scars can affect body image, especially during teenage years. Some families pursue umbilical reconstruction surgery for a better cosmetic appearance. Open communication about the condition helps children develop positive self-esteem.
What About Future Pregnancies?
Gastroschisis typically doesn’t run in families. The recurrence risk for subsequent pregnancies is low, similar to the general population risk.
Genetic testing usually isn’t recommended unless other structural abnormalities appear on ultrasound.
Questions to Ask Your Medical Team
Before Delivery:
- What category does my baby’s gastroschisis fall into?
- What facilities and specialists will be available at delivery?
- Should I deliver early or wait for spontaneous labor?
- What signs indicate I should go to the hospital immediately?
After Birth:
- What surgical approach will you use?
- How long do you expect my baby to stay in the NICU?
- What feeding challenges should I anticipate?
- What follow-up appointments will my child need?
Long-Term:
- What developmental screenings should my child have?
- Are there any activity restrictions as my child grows?
- What symptoms require immediate medical attention?
- When might additional surgeries become necessary?
Supporting Your Family
Parents of babies with gastroschisis face emotional stress, financial pressure, and practical challenges.
Connect with support organizations like The Global Gastroschisis Foundation (Avery’s Angels), which offers:
- Educational resources
- Care packages for families
- Connection to other parents
- Awareness campaigns each July (Gastroschisis Awareness Month)
Hospital social workers can help you navigate:
- Insurance coverage
- Medical leave from work
- Housing near the hospital
- Transportation assistance
- Mental health support
What Makes a Difference
The quality of care your baby receives—from prenatal monitoring through surgical repair and follow-up—directly impacts outcomes.
Key factors that improve results:
- Delivery at a specialized center with immediate surgical capability
- Experienced pediatric surgical teams
- Coordinated multidisciplinary care
- Appropriate timing of delivery based on fetal monitoring
- Avoiding unnecessary interventions (excessive fluids, routine intubation)
- Standardized feeding protocols
- Long-term developmental follow-up
Moving Forward
Gastroschisis changes your pregnancy journey and your baby’s first months, but it doesn’t define your child’s future.
Most children with gastroschisis grow into healthy adults who lead normal lives. They play sports, attend school without restrictions, and face no long-term limitations beyond occasional abdominal discomfort.
The medical advances of recent decades transformed gastroschisis from a devastating diagnosis to a manageable condition. Your baby is receiving care built on decades of research and surgical refinement.
You’re not alone in this journey. Thousands of families navigate gastroschisis each year, and medical teams across the country specialize in giving these babies the best possible start.