A Case of Gastroschisis in a Patient Who was Born at Home From a Mother Without Prenatal Care

Abstract

We report a case of a 0-day-old female neonate, whose mother’s pregnancy was determined in early gestation. Her mother had not visited a doctor since then and had not received prenatal care. She was delivered at home by vaginal delivery at 36 weeks and 6 days of gestation. The mother and neonate were both transferred to our emergency room because the neonate had gastroschisis with prolapse of the intestinal tract and bilateral oviducts. We performed silo placement on day 1, and the prolapsed organs gradually regressed into the abdominal cavity. The abdominal wall defect was covered with the umbilical cord on day 10, and the umbilical cord fell off on day 47. She was discharged on day 78 after the surgery with no serious complications such as sepsis. Neonates delivered from mothers without prenatal care have a poor prognosis. However, in cases such as gastroschisis with minor complications, if the care after birth is appropriate, the patient could be saved even if delivered at home. It is obvious that delivery from mothers without prenatal care involves high risk. From the characteristics of the mother, it is possible that in the future she will become pregnant again without prenatal care and deliver another infant with gastroschisis. There is an urgent need to develop a system to educate not only mothers but also fathers on the importance of prenatal care and fetal diagnosis.