I am just wondering how a Gastroschisis repair is performed while the baby is still in utero? And what the surgeons consider to come to the decision of doing this sort of repair before birth. As I know they usually do the surgery straight after the baby is born if the organs fit back into the abdominal.
Gastroschisis is NOT repaired in utero (fetal surgery during pregnancy) as the risks of such surgery are not warrented for this problem. Obstetrical management generally focuses on monitoring fetal growth, amniotic fluid volume and appearance of the herniated bowel. We also begin fetal well-being testing starting at 32 weeks into the pregnancy (28 weeks if the fetus is small or has low amniotic fluid levels) that includes biophysical profile and non-stress testing that gives us an idea if the fetus is stressed and needs to be delivered. Otherwise, most of these babies are delivered between 37 and 38 weeks, most are delivered vaginally and most do well. However, those that are complicated can be challenging, so recommendations are to be followed and deliver in a tertiary care center with a neonatal intensive care unit and pediatric surgeons that are experienced in managing these babies.
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