Neonatal gastroschisis associated with patent ductus arteriosus: a case report

Gastroschisis is a congenital abdominal wall defect that requires early prenatal diagnosis, close fetal surveillance, appropriate delivery planning, and timely multidisciplinary management to improve neonatal outcomes. We present the case of a 23-year-old pregnant woman from Tarapoto, Peru, at 33 weeks and 3 days of gestation, who presented with decreased fetal movements. Specialized ultrasound revealed fetal gastroschisis and a true umbilical cord knot. Given evidence of fetal distress, an emergency cesarean section was performed. A preterm female infant weighing 1850 g was born with Apgar scores of 8 and 9 at 1 and 5 min, respectively. At birth, neonatal gastroschisis with exteriorization of intestinal loops was confirmed, requiring silo placement followed by delayed surgical closure. During hospitalization, the newborn developed patent ductus arteriosus, which was managed medically, as well as suspected neonatal sepsis and feeding difficulties. Coordinated management by obstetrics, neonatology, pediatric surgery, and pediatric cardiology allowed progressive clinical stabilization, intestinal adaptation, and advancement of enteral feeding. The patient had a favorable clinical course and was discharged at 28 days of age. This case highlights the importance of adequate prenatal care, recognition of warning signs such as decreased fetal movements, timely referral for specialized assessment, and multidisciplinary management of newborns with gastroschisis and associated complications. It also provides a practical learning point for healthcare professionals involved in the prenatal and neonatal care of these patients.