It is possible for gastroschisis to be detected in the third month of pregnancy. However, we most often perform evaluations for it at 20-24 weeks, after it has shown up on an ultrasound. It is most commonly diagnosed by ultrasound around weeks 18-20 of pregnancy.
Some women are referred to us for gastroschisis late in pregnancy. We see them within two weeks of their referral. It is important to make a diagnosis and delivery plan as early as possible.
In babies with gastroschisis, the ultrasound will show loops of bowel floating freely. This often shows up when a woman goes in for a routine ultrasound with her obstetrician (OB). It is at this point that most of our patients affected by gastroschisis are referred to the Cincinnati Fetal Center. Here, we’ll work with you to assess how severe your case is and create a plan for the remainder of your pregnancy. We will also talk to you about what to expect after delivery.
An evaluation for gastroschisis consists of the following:
- An ultrasound (we can use an ultrasound performed within two weeks of your appointment with us, or one will be done on the day of your evaluation);
- Possibly an MRI and/or a fetal echocardiogram to test your baby’s heart function;
- A meeting with a nurse, social worker and genetic counselor;
- A team meeting with a maternal-fetal medicine specialist (MFM), pediatric surgeon and neonatologist.
An important part of the evaluation is determining whether the condition is gastroschisis or omphalocele. These conditions can sometimes look similar on an ultrasound. In omphalocele, a sac from the umbilical cord covers and protects the intestines that are outside of the baby’s body.
After your tests are complete, our team of experts meets with you to discuss the extent of the baby’s condition and its impact on the rest of the pregnancy. We’ll also cover medical treatments that might be needed right after the birth of your child, and long-term prognosis of babies with gastroschisis.
For patients who are local or plan to deliver locally, we also discuss the following:
We recommend frequent ultrasounds throughout the remainder of your pregnancy. These will help to monitor your baby’s health, the severity of the gastroschisis, and how it evolves.
Compassionate, Expert Care
The Cincinnati Fetal Center offers comprehensive diagnostic tests and the latest treatments for gastroschisis. Just as important, our team of specialists takes time to explain test results, answer questions and discuss treatment options. We understand that parents are facing unique challenges. We provide as much support as possible every step of the way. Extensive experience and expertise allow our team to treat the most complex cases of this condition.
Planning for Delivery
Normally we recommend our patients deliver at a level III hospital, which is one that can provide advanced trauma care. A children’s hospital should be nearby with a pediatric surgeon available to perform the surgery after your baby’s birth.
It is possible for a woman to have a vaginal delivery unless there are obstetric concerns. Your doctor may suggest a C-section at about 37 weeks of pregnancy if your baby’s lungs are mature enough.
For patients who deliver locally, your baby will be transferred to Cincinnati Children’s soon after delivery. Once you are stable, you will be given a pass from your delivery hospital to visit your baby until you are discharged. Your baby will stay in the NICU for a period of time after surgery.