References

Ailes EC, Dawson AL, Lind JN, Gilboa SM, Frey MT, Broussard CS, Honein MA Opioid prescription claims among women of reproductive age United States, 20082012. MMWR Morb Mortal Wkly Rep. 2015; 64:(2)37-41

Allman R, Sousa J, Walker MW, Laughon MM, Spitzer AR, Clark RH. The epidemiology, prevalence and hospital outcomes of infants with gastroschisis. J Perinatol. 2016; 36:(10)901-5 https://doi.org/https://doi.org/10.1038/jp.2016.99

Bar-Zeev S, Barclay L, Kruske S, Kildea S. Factors affecting the quality of antenatal care provided to remote dwelling Aboriginal women in northern Australia. Midwifery. 2014; 30:(3)289-96 https://doi.org/https://doi.org/10.1016/j.midw.2013.04.009

Bargy F, Beaudoin S. Comprehensive developmental mechanisms in gastroschisis. Fetal Diagn Ther. 2014; 36:(3)223-30 https://doi.org/https://doi.org/10.1159/000360080

Baud D, Lausman A, Alfaraj MA Expectant management compared with elective delivery at 37 weeks for gastroschisis. Obstet Gynecol. 2013; 121:(5)990-8 https://doi.org/https://doi.org/10.1097/AOG.0b013e31828ec299

Brown N, Nardi M, Greer RM Prenatal extra-abdominal bowel dilatation is a risk factor for intrapartum fetal compromise for fetuses with gastroschisis. Prenat Diagn. 2015; 35:(6)529-33 https://doi.org/https://doi.org/10.1002/pd.4535

Bulpitt DW, Elmore KE, Catterton LJ. Implementing use of donor breast milk in the well baby population: its not just for the NICU any more. J Obstet Gynecol Neonatal Nurs. 2014; 43:(S1) https://doi.org/https://doi.org/10.1111/1552-6909.12358

Carnaghan H, Baud D, Lapidus-Krol E Effect of gestational age at birth on neonatal outcomes in gastroschisis. J Pediatr Surg. 2016; 51:(5)734-8 https://doi.org/https://doi.org/10.1016/j.jpedsurg.2016.02.013

Csermely G, Susánszky É, Czeizel AE. Association of young and advanced age of pregnant women with the risk of isolated congenital abnormalities in Hungary – a population-based case-matched control study. J Matern Fetal Neonatal Med. 2015; 28:(4)436-42 https://doi.org/https://doi.org/10.3109/14767058.2014.918946

Faugstad TM, Brantberg A, Blaas HGK, Vogt C. Prenatal examination and postmortem findings in fetuses with gastroschisis and omphalocele. Prenat Diagn. 2014; 34:(6)570-6 https://doi.org/https://doi.org/10.1002/pd.4350

Feldkamp ML, Krikov S, Botto LD, Shaw GM, Carmichael SL Better diet quality before pregnancy is associated with reduced risk of gastroschisis in Hispanic women. J Nutr. 2014; 144:(11)1781-6 https://doi.org/https://doi.org/10.3945/jn.114.201376

Goetzinger KR, Tuuli MG, Longman RE, Huster KM, Odibo AO, Cahill AG. Sonographic predictors of postnatal bowel atresia in fetal gastroschisis. Ultrasound Obstet Gynecol. 2014; 43:(4)420-5 https://doi.org/https://doi.org/10.1002/uog.12568

Harper LM, Goetzinger KR, Biggio JR, Macones GA. Timing of elective delivery in gastroschisis: a decision and cost-effectiveness analysis. Ultrasound Obstet Gynecol. 2015; 46:(2)227-32 https://doi.org/https://doi.org/10.1002/uog.14721

Johnson S, Leeming D, Williamson I, Lyttle S. Maintaining the good maternal body: expressing milk as a way of negotiating the demands and dilemmas of early infant feeding. J Adv Nurs. 2013; 69:(3)590-9 https://doi.org/https://doi.org/10.1111/j.1365-2648.2012.06035.x

Kielb C, Lin S, Herdt-Losavio M Maternal periconceptional occupational exposure to pesticides and selected musculoskeletal birth defects. Int J Hyg Environ Health. 2014; 217:(2-3)248-54 https://doi.org/https://doi.org/10.1016/j.ijheh.2013.06.003

Lakhoo K. Fetal counselling for surgical conditions. Early Hum Dev. 2012; 88:(1)9-13 https://doi.org/https://doi.org/10.1016/j.earlhumdev.2011.11.004

Lepigeon K, Van Mieghem T, Vasseur Maurer S, Giannoni E, Baud D. Gastroschisis—what should be told to parents?. Prenat Diagn. 2014; 34:(4)316-26 https://doi.org/https://doi.org/10.1002/pd.4305

Mandelia A. Aetiology of left-sided gastroschisis. African Journal of Paediatric Surgery. 2015; 12:(2) https://doi.org/https://doi.org/10.4103/0189-6725.160440

Moore-Olufemi SD, Olsen AB, Hook-Dufresne DM, Bandla V, Cox CS Transforming growth factor-beta 3 alters intestinal smooth muscle function: implications for gastroschisis-related intestinal dysfunction. Dig Dis Sci. 2015; 60:(5)1206-14 https://doi.org/https://doi.org/10.1007/s10620-014-3439-1

Overcash RT, DeUgarte DA, Stephenson ML Factors associated with gastroschisis outcomes. Obstet Gynecol. 2014; 124:(3)551-7 https://doi.org/https://doi.org/10.1097/AOG.0000000000000425

Perry H, Healy C, Wellesley D Intrauterine death rate in gastroschisis following the introduction of an antenatal surveillance program: Retrospective observational study. J Obstet Gynaecol Res. 2017; 43:(3)492-7 https://doi.org/https://doi.org/10.1111/jog.13245

Rocha FG, Zalud I, Dye T. Ethnic variation of gastroschisis and omphalocele in the United States of America. J Matern Fetal Neonatal Med. 2014; 27:(14)1428-30 https://doi.org/https://doi.org/10.3109/14767058.2013.876002

Sadlier C. Helping children who require long-term parenteral nutrition: Management of intestinal failure can be challenging. Nursing Children and Young People. 2013; 25:(6)14-20

Simeone RM, Feldkamp ML, Reefhuis J CDC grand rounds. MMWR Morb Mortal Wkly Rep. 2015; 64:(39)1104-7 https://doi.org/https://doi.org/10.15585/mmwr.mm6439a3

Tarca E, Ciongradi I, Aprodu SG. Birth weight, compromised bowel and sepsis are the main variables significantly influencing outcome in gastroschisis. Chirurgia (Bucur). 2015; 110:(2)151-6

van Gelder MMHJ, Donders ART, Devine O Using bayesian models to assess the effects of under-reporting of cannabis use on the association with birth defects, national birth defects prevention study, 19972005. Paediatr Perinat Epidemiol. 2014; 28:(5)424-33 https://doi.org/https://doi.org/10.1111/ppe.12140

Wszolek K. Hand expressing in pregnancy and colostrum harvesting—preparation for successful breastfeeding?. British Journal of Midwifery. 2015; 23:(4) https://doi.org/https://doi.org/10.12968/bjom.2015.23.4.268

Gastroschisis: A review of practice

02 December 2017
11 min read
Volume 25 · Issue 12

Abstract

Gastroschisis is an abdominal wall defect in the fetus, affecting as many as 1 in 2000 pregnancies. This is a complex medical condition that is growing in prevalence worldwide, and one to which midwives will inevitably be exposed. There is a lack of consensus in the literature as to the cause of gastroschisis and for clear evidence-based treatment regarding indication and timing of birth. While it is agreed that specialist multidisciplinary collaboration is needed from pre-conception, through antenatal surveillance, and into labour, birth and postnatal care, the research is medically led, with no description of a midwifery role. In acknowledging that gastroschisis is a complex medical issue, specific medical and surgical interventions are not examined, but instead a midwifery plan of care within the multidisciplinary approach is derived from the available literature.

Gastroschisis is an abdominal wall defect in the fetus, affecting as many as 1 in 2000 pregnancies and growing in prevalence worldwide (Lepigeon et al, 2014). It occurs during the first trimester, and is caused when loops of bowel herniate outside the abdominal cavity in the amniotic fluid. This places the fetus at an increased risk of further complications, such as preterm labour, intra-uterine growth restriction (IUGR), fetal death in utero, bowel atresia, ischemia and volvulus (Carnaghan et al, 2016). The bowel continues to grow and develop outside the abdomen (Moore-Olufemi et al, 2015) until the fetus is born. At this point, immediate specialist intervention is needed because the exposed bowel places the neonate at risk of dehydration, hypothermia and infection (Lepigeon et al, 2014).

The contemporary literature acknowledges an increase in the global prevalence of gastroschisis in the past 30 years; however, a recent study suggests that there has been a significant stabilisation of figures, and in fact, a slight decrease has been noted (Allman et al, 2016). Research conducted in the USA found that the prevalence rate affected all demographics of age and ethnicity; however, Indigenous women in North America, Hawaii and the Pacific had higher rates of babies born with gastroschisis (Rocha et al, 2014).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • Unlimited access to the latest news, blogs and video content

  • Monthly email newsletter