Antenatally Diagnosed Gastroschisis: A Case Report

Introduction Gastroschisis is a congenital abdominal wall defect that has become increasingly common in the last 20 years [1]. We present a case of a newborn with antenatally diagnosed gastroschisis complicated by the late-onset sepsis and pneumonia. Case Presentation Fetus was diagnosed with gastroschisis antenatally in the 15th gestational week. Newborn was delivered naturally at 35 weeks. On the first day of life, the initial stage of surgical repair was performed, involving the placement of the intestines into a SILO bag. On the third day, the abdominal wall defect was successfully closed. On the ninth day, sepsis was suspected due to worsening respiratory failure and elevated C-reactive protein levels. Culture identified Staphylococcus haemolyticus in the bloodstream and Candida albicans in both the urine and surgical wound. A chest X-ray revealed pneumonia. During sepsis treatment, bowel obstruction was suspected, further diagnostic evaluation confirmed hydronephrosis and a patent foramen ovale. Discussion Gastroschisis is diagnosed antenatally in the first trimester of pregnancy [2]. There is no particular pathophysiological mechanism of gastroschisis and a couple options have been suggested [3]. The average prevalence of this disease in the EU is 1/6000 births and increasing [2], therefore it is necessary to acquire the knowledge of possible complications and how to manage them. Close fetal monitoring after diagnosis is mandatory due to high risk of fetal death [4]. Although the patient in this case initially had a high prognostic grade for gastroschisis and an uncomplicated presentation, the development of a severe complication of sepsis underscores the challenges of managing such cases. Conclusions We present the case of a newborn with gastroschisis complicated by pneumonia, sepsis, and candidiasis. Early antenatal diagnostics and multidisciplinary care during the gestational period led to good outcome despite complications.