An infant delivered by cesarean and noted to have gastroschisis should be managed with which measure to prevent evaporative heat loss from the exposed intestines?

• A. Place infant in a sterile bowel bag
• B. Wrap the abdomen with a towel
• C. Place the infant under a standard radiant warmer without barriers
• D. Apply petroleum jelly directly to the exposed bowel

Answer: (A)

When the intestines are exposed in gastroschisis, a large surface area can rapidly lose heat to the surroundings, risking hypothermia. The most effective immediate step is to create an occlusive, sterile barrier over the exposed bowel to preserve heat and moisture and protect against contamination. A sterile bowel bag does exactly this: it covers the intestines with an impermeable, sterile layer, helping maintain warmth and humidity until surgery can repair the defect. This approach reduces evaporative heat loss far better than simply wrapping with a towel or placing the infant under a radiant warmer without a barrier, which still allows the exposed viscera to evaporate moisture. Applying petroleum jelly directly to the exposed bowel does not provide an adequate barrier and can complicate later surgical handling. So, using a sterile bowel bag offers the best protection for thermoregulation in this scenario.