Logan’s Recovery from Gastroschisis

Getting ready to turn 2, Logan has a big appetite. He enjoys eating now but his first few months of life were very difficult.  When his mom, Laurie, was 20 weeks pregnant, a routine ultrasound alerted doctors about a problem with his intestines.

“It was kind of shocking and a little devastating. Because no mom wants to hear that there's anything different with their babies, you know?” said Laurie Hittle, Logan’s mom. “Especially the first one. That's a little scary.”

Logan was diagnosed with gastroschisis. It’s a birth defect that develops in a baby while in utero. With this condition, an opening forms in the baby’s abdominal wall. The baby’s bowel pushes through this hole. The bowel then develops outside of the baby’s body in the amniotic fluid. As a result, it can become irritated, swollen, and damaged putting the baby’s health at risk. This occurs in about one in every 2,000 births.

“It's hard for a mom to find out that her baby has something, and we need to make sure we are with her in this path from the beginning and taking care of her health and her baby,” said Mounira Habli, MD, Maternal-Fetal Medicine Specialist, Fetal Care Center.

Cincinnati Children’s Fetal Care Center specializes in treating complex and rare fetal conditions including gastroschisis. Since the baby will need surgery right after birth, healthy moms have the option of delivering in the Special Delivery Unit. It is one of only a few birthing centers in the world located inside a pediatric hospital allowing mom and baby to recover near each other.

“We will develop a multidisciplinary team taking care of the mom from the obstetric care first, that means we will meet neonatology will meet pediatric surgery and we will meet the maternal fetal medicine specialist,” Dr. Habli said. “We will develop a plan of care from the time of diagnosis until the delivery.” 

At Cincinnati Children’s, the pediatric surgical team from the Intestinal Rehabilitation Center works in conjunction with neonatology to explore the best options for surgical repair.

“In the setting of the bowel, if it looks healthy and it's not very inflamed looking, it may be possible to reduce the bowel all back into the tummy, primarily right away at the time of birth. And then close the abdomen,” said Paul Wales, MD, surgical director for the Intestinal Rehabilitation Center. 

However, some cases, like Logan’s, are more complicated. He needed what is called a staged repair. That is when a plastic pouch or “silo” is placed around the bowel and attached to the belly. Every day, the silo is tightened and some of the bowel is gently pushed inside. When all of the bowel is inside, the silo is removed, and the belly is closed. This takes place over several days and can last up to two weeks.

“I'm always amazed when I see these babies at birth, and we put the bowel in a silo how we're able to get that bowel back into the tummy in such a short period of time,” Dr. Wales said. “I'm always still amazed by how the tummy is able to stretch and accommodate the bowel as we are able to reduce it. It's quite remarkable actually.”

For more complex cases where babies suffer from intestinal failure, Cincinnati Children’s is also unique in that it offers a multidisciplinary intestinal rehabilitation program.

This includes specialized intestinal reconstructive surgery, long-term nutritional and developmental follow up, remote patient monitoring and transplantation when needed.

Logan spent 75 days in the Newborn Intensive Care Unit (NICU) recovering. He has since healed and now returns to the hospital every 6 months to consult with the NICU Follow-up Clinic and other specialists as part of his continuum of care.

“We're very happy that he's here. We're lucky that everything worked out as well as it did,” Laurie said. “But of course, we just love them to pieces. And we're happy that everything worked out as well as it did.”

Cincinnati Children's Fetal Care Center

Experts in maternal-fetal medicine, neonatology and fetal surgery share a passion for providing exceptional, comprehensive care for mothers and babies experiencing complex fetal conditions or high-risk pregnancy.

Our team provides care in an atmosphere of compassion, knowing that patients and families are sometimes dealing with difficult decisions.

We offer prenatal evaluation, fetal diagnosis and treatment services that consider both you and your baby.

The Fetal Care Center offers a comprehensive, integrated approach to patient care:

• Consistency: The same team of physicians cares for patients from diagnosis to treatment and follow-up.
• Collaboration: Physicians from many medical specialties share their expertise to ensure that each aspect of a child’s care is addressed.
• Sophisticated treatment options: Our experience and commitment to research mean that we can provide the most effective therapies available.
• Family-centered care: Collaboration is at the heart of our approach. We encourage parents to participate in every aspect of their child’s care and we value their input.