An unusual cause of delayed full enteral feeding and prolonged hospital stay in a newborn with gastroschisis: Congenital Hypothyroidism

Gastroschisis, is a prevalently encountered congenital disease of the newborns where intraabdominal organs protrude through a full-thickness defect in the anterior abdominal wall without an overlying sac. In recent years, an increase in the global incidence of gastroschisis has been reported. Although its etiology is not known fully, it is usually associated with young maternal age. Delay in the transition to full-calorie enteral feeding (ENT) in a newborn with gastroschisis is a result of bowel dysfunction which is a major morbidity developing due to exposure of bowels to amniotic fluid. Consequently, newborn may require long-term TPN treatment, and sepsis may onset secondary to prolonged mechanical ventilation, and TPN treatment, and infection,. Global incidence of congenital hypothyroidism (CH) in live births is 1:3000-4000. Widely encountered symptoms may include prolonged jaundice, constipation, distended abdomen, and poor feeding. The diagnosis should be confirmed by finding an elevated serum TSH and low T4 or free T4 level. In the literature, transient hypothyroidism has been reported in cases who underwent only silo operation, and povidone iodine dressings,. Association of hypothyroidism with delayed transition to full enteral feeding, and prolonged hospital stay in gastroschisis has not been reported previously. In newborns with gastroschisis who underwent primary facial repair, thyroid functions should be controlled at appropriate times, and followed up closely.