Monday it seemed that everywhere I looked there was a pregnant girl. When I was a teenager pregnant girls were not allowed to go to school with the general populous. They were ever sent to night school or to some family member in another state where they had the baby and gave it up for adoption. With so many childless parents out there today it makes me wonder why these young girls....who are children themselves....are choosing to have the child and raise it. Answer....they don't raise them....grandma or momma raise them. Most of the young girls who have had, or are currently expecting, still continue on with their youthful high school life. They are on the dance team....they are cheerleaders.....they hang our with friends on Friday night.....there is no consequence for their action. One of my students told me today that she was 5 months pregnant. For someone older I would have been so excited and congratulated her....but I sadly looked at my student and said, "I am so sorry." She looked at me as if I were crazy....but I was sorry. Sorry that her life is going to be interrupted. What could have been a carefree youth....is now going to be filled with baby diapers and 3 am feedings. School is hard enough without that tacked on. But...That is where the problem lies with most of the kids today....there are no consequences. When I got in trouble at school I knew when I got home it would be twice as bad as it was at school....not any more.....but this past week I found out that one of our students has a problem with her baby. Actually she has multiple problems. Back before Christmas she had an amnio and one of the biggies discovered was that this child has gastroschisis. I had no idea what that was....it just sounded horrible.....so I went searching. What I found was not good.....not good at all. Gastroschisis refers to babies born with organs outside the body. Gastroschisis is one of the most frequently encountered congenital anomalies in pediatric surgery. This condition happens about 1 inevery 2,000 births. Gastroschsis is a defect or hole in the abdominal wall that lets the abdominal contents protrude outside the body. There is no peritoneal covering over the intestines and other organs. The hole is usually very small, but the exposed contents can range from the stomach to the rectum (almost all of the large and small intestine and stomach can be involved). The abnormality can be seen by ultra sound as early as 14 weeks of pregnancy. Most often (75% of the time) it occurs with the first born baby. The malformation is always obvious at birth. It is a very frightening experience for new parents, but, in most cases, the defect can be totally repaired and the baby will completely recover. Since the bowel is not contained inside the body, before birth, it floats freely in the amniotic fluid. Contact with the amniotic fluid can cause severe damage. The bowel can fail to grow, become thickened, matted, or shortened with poor mucosal function. The damage becomes more severe with prolonged exposure to the amniotic fluid, especially after thirty-five weeks gestation, so some physicians suggest early Cesarean delivery to limit bowel damage. Sometimes the physician performs weekly ultrasounds from thirty weeks on to watch for bowel wall thickening and when thickening is observed hedelivers the baby by Cesarean delivery to limit bowel damage. There are many studies that claim there are no significant benefits of early Cesarean delivery over vaginal delivery at term.
Immediately after birth, any organs outside the baby's body are covered with warm, moist sterile bandages and then placed inside a special plastic pouch. A nasogastric (NG) tube is placed in the baby's nose or mouth to keep the stomach empty and to prevent chocking on or breathing in any stomach contents. As soon as the infant is stable, surgery is done to put the intestines and organs back into the body. The surgeon examines the intestines to make sure there is no damage and that the edges of the intestines aresealed. The organs are placed back into the abdomen through the defective opening and the opening is repaired. Sometimes all the contents cannot fit back into the abdomen with the first surgery. The remaining intestines are put in the plastic pouch and are slowly pushed back into the abdomen over a period of time. Additional surgeries may be needed to repair the abdominal muscles at a later time. Because the baby's abdomen may be smaller than normal, placing the intestine in the abdomen increases the pressure within the area and may cause breathing difficulties. The baby may need to be placed on a ventilator to breathe for him for a few days or weeks. The baby will be given IV fluids, antibiotics, pain medication and oxygen. An NG tube will be used to keep the stomach empty until the intestines start to work normally and then normal feeding are very slowly started. In most instances gastroschisis can be totally corrected with surgery. I don't think it is the case in this students....because there are so many other problems. Keep her in your prayers and thoughts. It would be an difficult undertaking for a pair of parents who are mature enough to handle it....but for a 16 year old this would be earthshaking.
Tuesday, February 1, 2011
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