Gastroschisis

Any parent who faces the traumatic experience of having his or her child diagnosed with a birth defect usually responds emotionally. While this primary response is expected and natural, it should be followed with a determination to gain enough knowledge about the infant’s condition to make informed medical decisions possible. Gastroschisis is a birth defect that involves a hole in the abdominal wall near the navel through which the child’s bowels protrude. Often the condition is visible in ultrasounds or detected through prenatal blood tests in the second trimester, giving the doctor a chance to monitor the baby’s condition and allowing the parents time to educate themselves and plan treatment. Gastroschisis is usually quite treatable. Surgery soon after birth often corrects gastroschisis, but there are two approaches.

The preferred method of correcting gastroschisis is primary repair surgery soon after birth. The protruding bowels are coaxed back through the hole into the abdominal cavity, and the opening is sutured. This method reduces the chance of infection and loss of fluid. The other approach to correcting gastroschisis is a staged repair. This is necessary when the exposed bowels are irritated and swollen, and the abdominal cavity is too small. In this method, a plastic covering called “silo” is placed over the protrusion. This is reduced every day until the skin surface is level, and the hole can simply be sutured closed. There are more risks involved in a staged repair, as contamination and loss of body heat are issues. With both procedures, intravenous feeding and sometimes the use of a ventilator are common.

While visually unsettling, gastroschisis can be effectively treated. Early detection is common, making the chances of success higher, as mother and child are carefully watched for distress. Parents who arm themselves with information about gastroschisis are better prepared for the appearance of their infant’s defect and are ready to act more confidently in the face of medical decisions. If you have received a diagnosis of gastroschisis for your infant, arm yourself with knowledge. You will be grateful you took the time.

Congenital Diaphragmatic Hernia

All parents dream of having a healthy baby and often hold their breath as all the fingers and toes are being counted. The hard reality is that not every baby is born perfect, no matter how careful the parents are during pregnancy. Congenital Diaphragmatic Hernia is one of many possible devastating conditions a baby may face. This defect involves the lungs and intestines and occasionally the heart, liver, or stomach. Congenital Diaphragmatic Hernia is treatable. The baby’s condition at birth dictates the immediate treatment of Congenital Diaphragmatic Hernia.

As the name implies, Congenital Diaphragmatic Hernia is the diagnosis of a baby born with a hole in the diaphragm, an important muscle that aids in breathing and keeps the abdominal muscles out of the chest cavity. The hole is a problem because it allows the organs to enter the chest cavity, inhibiting the normal development of the lungs. 90% of Congenital Diaphragmatic Hernia cases occur on the left side of the body (Bochdalek) and involve the intestines and stomach. 2% occur on the right side (Morgagni) and involve the intestine and liver. The main threat from Congenital Diaphragmatic Hernia is that oxygen flow is depleted because the lungs did not develop properly.

Congenital Diaphragmatic Hernia is sometimes detected by ultrasound and can be surgically treated before week 26 to minimize the damage. The procedure keeps fluid in the lungs of the fetus, aiding growth of the lungs. When a baby is diagnosed at birth, however, neonatal intensive care is required. A baby with a Congenital Diaphragmatic Hernia is usually put on a ventilator. If breathing problems are more severe, the baby will be temporarily put on a heart-lung bypass machine. Not until a baby’s condition is stabilized is the condition operable. While surgery can go a long way toward fixing the problem, a child may still face difficulties, such as chronic lung disease, failure to thrive, gastroesophageal reflux, and a lag in the development of gross motor skills. These problems may be long lasting.

If you have a child facing Congenital Diaphragmatic Hernia, it is best to learn all you can in order to make informed decisions. Understanding a medical condition more fully often gives you more choices and makes you better equipped to follow the information given by doctors and other medical personnel. Take a proactive approach to your child’s condition: equip yourself with knowledge.