Gastroschisis

Clinical Description

• This is a birth defect in the abdominal wall where the baby’s intestines are found outside the baby’s body exiting through a hole beside the umbilicus.
• This differs from Omphalocele where the defect is paraumbilical and has associated intestinal abnormalities. They are more often noted in syndromic babies or noted to have other associated system abnormalities.

Treatment

• In the case of a gastroschisis, these babies have to be referred to a tertiary hospital at the earliest convenience. But before referral, the baby needs to be stabilized in the following way

Non-pharmacological

• Keep baby warm and check the random blood sugar
• Cover bowels with a plastic. Do not cover with wet gauze as this makes the babies prone to hypothermia from the evaporation of the fluid
• Insert an Orogastric Tube for decompression

Pharmacological

• Establish IV access and give maintenance fluids (see paediatric section of fluid

Treatment

• Give Benzylpenicillin 50,000 iu/kg/dose STAT
• Give Gentamycin 3.5mg/kg (preterm neonate) or 5mg/kg (term neonate) STAT
• Give Vitamin K 0.5mg-1mg STAT

Referral with health personnel