Gastroschisis is a birth defect where a hole in the abdominal wall allows intestines to protrude outside the baby's body. It occurs in about 0.1-0.3% of live births. The defect is usually on the right side of the belly button, with no protective sac covering the intestines. Treatment involves surgery to return the intestines to the abdominal cavity. Nursing care focuses on keeping the exposed intestines warm and sterile, managing fluids and nutrition, and monitoring for complications like infection or obstruction. Primary repair is preferred if the intestines will fit back inside, otherwise a staged repair using a synthetic sac is required.

1. GASTROSCHISIS
Prepared by:
Estrada, Sharmaine P.
PCU-MJCN, SN

2. GASTROSCHISIS
 Is a congenital malformations in which a defect
in the abdominal wall allows portions of the
abdominal contents to herniate outside the
abdominal cavity.
 Their incidence is 0.1 to 0.3 percent of 1,000
live births.
 The defect in the abdominal wall permits
extrusions of the abdominal contents, primarily
the small and the large intestines, without
involving the umbilical cord

3.  The defect is usually at the right
side of the umbilicus, and there is
no protective sac covering the
intestines.
 The etiology is unclear, although
one theory explains gastroschisis
as resulting from an incomplete
lateral in infolding of the
embryonic disc, which allows
herination of the bowels

6. ASSOCIATED ANOMALIES
 Prematurity
 Malrotation of the intestines
 Decreased abdominal capacity
 Atresia
 Stenosis
 Meckel’s diverticulum

7. CLINICAL MANIFESTATIONS
 In Gastroschisis
the bowel
eviscerates into
the amniotic
cavity, and
exposure to the
amniotic fluid
results in
thickened, beefy-
red, edematous
intestines.

8. THERAPEUTIC MANAGEMENT
 When bowel obstruction in confirmed, an
orogastric o nasogastric tube in inserted and
then attached to low suction or left open to the
air to prevent further gastrointestinal distention
from swallowed air.
 Intravenous therapy is necessary to restore fluid
 Immediate surgery is scheduled because bowel
obstruction is an emergency that must be
treated before dehydration
 ,electrolyte imbalance, or aspiration of vomitus
occurs

9. NURSING MANAGEMENT
 Thermoregulation is critical because significant
heat loss can occur through the exposed
intestines . Use warmers and monitor the
child’s temperature
 Use sterile technique in dealing with the defect.
Immediately cover w/ warm, moist, sterile gauze;
and wrap w/ plastic to keep moist.
 minimize movement of the infant and handling
of the intestines.

10.  Assess for circulatory compromise, obstruction,
sepsis: monitor temperature, pulses, capillary
refill time, skin color, changes in the respiratory
patterns and heart rate.
 Observe for respiratory distress secondary to
high intraabdominal pressure as the gut returns
to the peritoneal cavity.
 Fluid-volume management is crucial nursing
responsibility: monitor intake and output and
daily weights, assess fontanels and maintain IV
line.

11.  Maintain NG tube for decompression, monitor
bowel sounds and stools, measure abdominal
girth.
 Maintain parenteral nutrition to sustain growth
 Offer pacifier to meet sucking needs
 Provide emotional support for parents as they
deal with the loss of the “perfect child”
 Encourage parents to provide care as they are
able, talk to and touch infant, and hold the
infant when appropriate.

12. TWO ACCEPTED SURGICAL TECHNIQUES
 Primary Repair
- is the
procedure of
choice if the
abdominal
contents will fit
into the
abdominal cavity.

13.  Staged Repair
- a synthetic
material
(silastic) is used
to create a sac
to cover the
abdominal
contents.