Care Protocol for Newborns with Gastroschisis: An Evidence-Based Proposal

Abstract

Gastroschisis is a congenital abdominal wall defect characterized by the herniation of the intestinal loops and, occasionally, other abdominal organs through a defect typically located to the right of the umbilical cord, without a protective membranous covering. Its estimated incidence is approximately 1 per 4,000 live births and has increased over recent decades. Young maternal age is recognized as one of the main risk factors, with a higher prevalence among infants born to adolescent mothers and preterm newborns. In addition, gastroschisis may be associated with intestinal anomalies such as atresia, stenosis, perforation, or necrosis, a condition referred to as complex gastroschisis, which is associated with increased neonatal morbidity and mortality as well as prolonged hospitalization.

Prenatal diagnosis by ultrasonography enables early detection of the defect, facilitates pregnancy surveillance, supports multidisciplinary care planning, and assists in determining the optimal timing of delivery, thereby promoting timely surgical intervention and improved clinical outcomes. In this context, the standardization of neonatal management represents a key strategy to optimize care, reduce variability in clinical practice, and improve patient outcomes. Accordingly, a comprehensive review of the available scientific literature was conducted to develop a proposed protocol for the management of newborns with gastroschisis, based on the best available evidence. The proposed protocol aims to standardize diagnostic and therapeutic interventions from birth through the initial postoperative period, promoting comprehensive, safe, and high-quality neonatal care.