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What’s the Difference Between Gastroschisis and Omphalocele?

Overview

Key points

  1. Gastroschisis and omphalocele are two rare birth defects.
  2. These conditions may be more common in babies born to teenage mothers.
  3. Both conditions are usually treatable shortly after birth.

Gastroschisis and omphalocele are two rare birth defects that cause a baby to be born with some of their internal organs extending out of the body through a hole in the belly. These conditions differ in some important ways. But how they present is similar, as are the treatments.

Both conditions are visible at birth, and both can affect how a newborn digests food. In both cases, a doctor will perform surgery to put the intestines and any other affected organs into their proper locations.

Keep reading to learn more about the similarities and differences between the two conditions.

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Symptoms

Symptoms

Both omphalocele and gastroschisis share one major characteristic. In both conditions, a baby’s intestines extend out of a hole in the belly. In some cases, other organs like the liver or stomach also push out through the hole.

There are some key differences between these two serious conditions.

omphalocele gastroschisis
hole in belly button hole next to belly button
intestines covered by protective sac intestines not covered by a protective sac
 

Omphalocele

In babies with omphalocele, the hole is in the belly button. A transparent, membranous sac covers the intestines and any other exposed organs. This sac helps protect the organs from the amniotic fluid that surrounds a baby in the womb.

In the early stages of pregnancy, it’s common for the intestines and other internal organs to extend from the belly into the umbilical cord. Usually by the 11th week of pregnancy the organs retreat inside the abdomen. Omphalocele occurs when the organs fail to move back into the abdomen.

Gastroschisis

Gastroschisis results when there is a problem with the belly wall. In this case, the hole forms next to the belly button, allowing the intestines to push through. The hole may be small or large. Usually the hole is on the right side of the belly button.

Another important difference is that with gastroschisis, there is no protective sac that surrounds the exposed organs. This means amniotic fluid can irritate the intestines. They can end up swollen or twisted.

Causes

Causes

The causes of gastroschisis and omphalocele aren’t well understood. Researchers believe the conditions develop because of abnormal changes in genes or chromosomes. Exposure to environmental toxins or medications could cause some of these changes. There still needs to be more research done to better understand the causes.

Talk to your doctor if you’re pregnant and concerned about exposure to something that may be harmful to your unborn child. They can help determine any appropriate tests you should have during pregnancy, or conditions they may want to test for after birth. Your doctor can also connect you with a genetic counselor who can help you understand the risks.

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Risk factors

Risk factors

It’s not clear why some women give birth to babies with gastroschisis or omphalocele. The Centers for Disease Control and Prevention (CDC) reports that teenage mothers have a higher risk of having a baby with gastroschisis than older mothers.

CDC researchers also identified more risks for omphalocele. These include:

  • drinking alcohol or smoking more than a pack of cigarettes per day during pregnancy
  • taking antidepressant medications called selective serotonin-reuptake inhibitors (SSRIs) while pregnant
  • being obese during pregnancy

Incidence

Incidence

Gastroschisis occurs more often than omphalocele. But both conditions are considered rare. The National Institutes of Health reports that about 2 to 6 out of 10,000 newborns in the United States are born with gastroschisis. Two to 2.5 newborns out of 10,000 have omphalocele. These conditions, called abdominal wall defects, may be occurring more often.

Also, white teens are more likely than African-American teens to give birth to a child with gastroschisis.

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Diagnosis

Diagnosis

For both omphalocele and gastroschisis, the abnormal location of the organs is usually seen with an ultrasound during pregnancy. These conditions are usually seen once a woman reaches her second or third trimester. An ultrasound is a painless, noninvasive imaging technique. It uses sound waves to create moving and still pictures of the inside the body.

If your doctor discovers your baby has omphalocele or gastroschisis, they may order a fetal echocardiogram to look for heart defects. An echocardiogram is an ultrasound of the heart. Your doctor, a neonatologist, a pediatric surgeon, and the rest of your healthcare team will help you with figure out a plan to have a healthy pregnancy and delivery.

A neonatologist is a doctor who specializes in caring for newborn babies. Knowing early that your baby will be born with an abdominal wall defect can help make sure treatment can begin as soon as possible.

Learn more: Birth defects »

You’ll receive regular ultrasounds and periodic blood tests throughout your pregnancy. An abnormal reading on a routine blood test may alert your doctor to look for symptoms of an abdominal wall defect or another birth defect.

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Treatment

Treatment

Surgery to place the organs back inside the baby’s belly is necessary for both conditions. If the hole is small and only a small part of the intestines is pushing through, the operation may take place soon after birth.

If there is a larger opening with more of the intestines and other organs visible, treatment may require more than one surgery. The surgeries would occur in stages over a period of time. The hole is closed once the organs are in the correct positions inside the belly.

In addition to the size of the hole, the baby’s age is a factor in deciding when and how to operate. A baby born prematurely may need to wait for surgery until they are a little bigger and stronger.

Treatment usually includes giving the baby nutrients and fluids through an IV. Antibiotics are usually given to help prevent an infection. Care also includes monitoring of the baby’s body temperature and warming them as needed.

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Complications

Complications

Though it’s not clear why, many newborns with omphalocele or gastroschisis also have other birth defects, such as congenital heart defects. If there are other birth defects, that could affect treatment of the abdominal wall defect.

Because some of the organs grew on the outside of the baby’s body, the space inside the abdomen that normally contains those organs might not have grown big enough. If the sac around the organs in babies with omphalocele breaks, there is a risk of infection. There may also be problems with one or more of the exposed organs. An organ may grow abnormally or be twisted and experience reduced blood flow that could harm the health of the organ.

Outlook

Outlook

Despite possible complications, surgical treatment of gastroschisis and omphalocele is often successful with no long-term health problems. Babies born with either of these conditions tend to be smaller than average, so they may take longer to develop. It may take a little time for them to become successful at feeding and to have a completely healthy digestive system. With proper care after surgery, these babies can catch up to their peers.

The possibility of other birth defects is somewhat higher in babies with these conditions, so it’s important that your doctor checks for problems with the heart and other organs, as well as problems with genes or chromosomes.

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