Abdominal wall defects are a group of birth defects where the abdominal wall did not close properly during fetal development, leaving an opening where intestines and organs come through. Prenatal screening is often used to detect abdominal wall defects. In many cases, an elevated second trimester maternal serum alpha-fetoprotein is discovered which may indicate the defect. Most abdominal wall defects can be surgically repaired at birth.
Gastroschisis is the most common abdominal wall defect. In it, the intestines are located outside the abdomen, usually to the right of the umbilical cord and floating free in the amniotic fluid. When the intestines are exposed to the fluid, it causes a film to develop around the intestine, which may affect normal intestinal functions after delivery. About 10–15 percent of babies with gastroschisis may also develop atresia, a condition where part of the intestine fails to form. More information can be found at the American Pediatric Surgical Association.
In omphalocele, the intestines are located outside of the abdomen and covered by a thin sac. The abdominal contents stick out through the belly button. Up to one-third of infants with an omphalocele may have other birth defects. More information can be found at American Pediatric Surgical Association.
Gastroschisis and omphalocele are usually diagnosed by ultrasound examinations before birth. These tests can determine the size of the abdominal wall defect and identify the affected organs.
Exstrophy is another abdominal wall defect. Here, the abdominal wall and pelvic bones did not grow together, leaving an opening. The bladder and sometimes the intestines turn inside out and bulge through the opening. There are two types of exstrophy. In cloaca exstrophy, the intestines and bladder are outside of the body. In bladder exstrophy, only the bladder is located outside of the body. A helpful Web site is American Urological Association.
Hospital Stay
Babies with these surgeries may stay in the hospital for weeks or months, recovering and waiting for the gastrointestinal tract (feeding) to work completely. It is not known in many cases why some babies need to stay longer than others.