Background: Anterior abdominal wall defect is a spectrum of congenital malformations arising from defective fusion or development of the embryonic folds. Gastroschisis and omphalocele constitute the majority of cases. Methods: A retrospective study of newborns with anterior abdominal wall defects at our facility from February 2012 to June 2023. Results: A Total of 142 newborns presented with anterior abdominal wall defects. Females 74 and males 68, ratio of 0.9:1. Median age at presentation was 18.5 hours. Mean birth weight was 2.6 ± 0.6 kg, range of 1.1 kg - 4.2 kg. There were 120 (83.8%) newborns with omphalocele, 14 (9.9%) with gastroschisis, prune belly 3 (2.1%), bladder exstrophy, cloacal exstrophy, a set of conjoined twins and pentalogy of Cantrell 1 (0.7%) each. Of the 120 with omphalocele, 107 were omphalocele major, 13 omphalocele minor while 45 (37.5%) presented with ruptured membrane. Complication: sepsis (38, 26.7%). Length of hospital stay 0.2 days - 63 days, mean of 15 days. Mortality 62 (43.7%), treated and discharged home 80 (56.3%). Of the 62 mortalities, 45 (72.6%) occurred in week one. Case fatality rate: pentalogy of Cantrell 1(100%), Gastroschisis 13 (92.85%) and omphalocele major 44 (41.1%). Of the 44 mortalities with omphalocele major, 26 (51.1%) had ruptured membranes. Logistic regression: birth weight (OR = 0.209, CI = 0.083 - 0.525, p = 0.001); Duration of hospital stay (OR = 0.287, CI = 0.287 - 9.985, p < 0.001) and type of defect (OR = 0.449, CI = 0.276 - 0.731, p = 0.001) significantly predicted mortality. Conclusion: Low birth weight and type of defect (ruptured omphalocele and gastroschisis) were significant predictors of mortality.
(2024) Data and Statistics on Birth Defects. Centers for Disease Control and Prevention. https://www.cdc.gov/birth-defects/data-research/facts-stats/
[3]
Keppler-Noreuil, K.M., Conway, K.M., Shen, D., Rhoads, A.J., Carey, J.C., Romitti, P.A. and National Birth Defects Prevention Study (2017) Clinical and Risk Factor Analysis of Cloacal Defects in the National Birth Defects Prevention Study. American Journal of Medical Genetics Part A, 173, 2873-2885. https://doi.org/10.1002/ajmg.a.38469
Lee, R., Dassios, T., Ade-Ajayi, N., Davenport, M., Hickey, A. and Greenough, A. (2024) Predictors of Outcomes in Infants with Gastroschisis Treated with a Preformed Silo. Pediatric Surgery International, 41, Article No. 22. https://doi.org/10.1007/s00383-024-05922-7
[6]
Shitta, A.H., et al. (2020) Ruptured Omphalocele and Gastroschisis: An 8 Year Experience with the Use of Female Condom (Femidom) as an Improvised Silo. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 19, 38-43.
[7]
Utama Putri, D. and Ponco Wibowo, Y. (2024) Prevalence, Management and Outcome of Gastroschisis: A Comprehensive Systematic Review. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 10, 400-407. https://doi.org/10.61841/jghz5x97
[8]
Rahayatri, T.H., Gunardi, H.D., Amin, R.B.M. and Tamba, R.P. (2024) Gastroschisis Survival Improvement and Early Intervention: Experience in a Developing Country. PaediatricaIndonesiana, 64, 264-269. https://doi.org/10.14238/pi64.3.2024.264-9
[9]
O'Connell, R.V., Dotters-Katz, S.K., Kuller, J.A. and Strauss, R.A. (2016) Gastroschisis: A Review of Management and Outcomes. Obstetrical & Gynecological Survey, 71, 537-544. https://doi.org/10.1097/ogx.0000000000000344
[10]
Conner, P., Vejde, J.H. and Burgos, C.M. (2018) Accuracy and Impact of Prenatal Diagnosis in Infants with Omphalocele. Pediatric Surgery International, 34, 629-633. https://doi.org/10.1007/s00383-018-4265-x
[11]
Nembhard, W.N., Bergman, J.E.H., Politis, M.D., Arteaga-Vázquez, J., Bermejo‐Sánchez, E., Canfield, M.A., et al. (2020) A Multi-Country Study of Prevalence and Early Childhood Mortality among Children with Omphalocele. Birth Defects Research, 112, 1787-1801. https://doi.org/10.1002/bdr2.1822
[12]
Raymond, S.L., Hawkins, R.B., Peter, S.D.S., Downard, C.D., Qureshi, F.G., Renaud, E., Islam, S., et al. (2020) Predicting Morbidity and Mortality in Neonates Born with Gastroschisis. Journal of Surgical Research, 245, 217-224. https://doi.org/10.1016/j.jss.2019.07.065
[13]
Brebner, A., Czuzoj-Shulman, N. and Abenhaim, H.A. (2020) Prevalence and Predictors of Mortality in Gastroschisis: A Population-Based Study of 4803 Cases in the USA. The Journal of Maternal-Fetal & Neonatal Medicine, 33, 1725-1731.
[14]
Wesonga, A.S., Fitzgerald, T.N., Kabuye, R., Kirunda, S., Langer, M., Kakembo, N., et al. (2016) Gastroschisis in Uganda: Opportunities for Improved Survival. Journal of Pediatric Surgery, 51, 1772-1777. https://doi.org/10.1016/j.jpedsurg.2016.07.011
[15]
Biswas, I., Sultana, S., Jahan, N. and Huq, U. (2024) Factors Influencing the Survival of Patients with Gastroschisis in A Lower-Middle Income Country: A Retrospective Observational Study. Clinical Research, 1, 22-27.
[16]
Chidiebere, O.D., Uchenna, E., NduIkenna, K., Christian, I., Nwabueze, A.I., AmadiOgechukwu, F., et al. (2018) The Low-Birth Weight Infants: Pattern of Morbidity and Mortality in a Tertiary Healthcare Facility in the South Eastern Nigeria. Annals of Medical and Health Sciences Research, 8, 4-10
[17]
Biswas, I., Sultana, S., Jahan, N. and Huq, U. (2024) Factors Influencing the Survival of Patients with Gastroschisis in A Lower-Middle Income Country: A Retrospective Observational Study. Clinical Research, 1, 22-27.
[18]
Kusuda, S., Fujimura, M., Sakuma, I., Aotani, H., Kabe, K., Itani, Y., et al. (2006) Morbidity and Mortality of Infants with Very Low Birth Weight in Japan: Center Variation. Pediatrics, 118, e1130-e1138. https://doi.org/10.1542/peds.2005-2724
[19]
Agarwal, R. (2005) Prenatal Diagnosis of Anterior Abdominal Wall Defects: Pictorial Essay. Indian Journal of Radiology and Imaging, 15. https://link.gale.com/apps/doc/A158965138/HRCA?u=anon~443ff1c0&sid=googleScholar&xid=7816f885
[20]
Barisic, I., Clementi, M., Haeusler, M., Gjergja, R., Kern, J. and Stoll, C. (2001) Evaluation of Prenatal Ultrasound Diagnosis of Fetal Abdominal Wall Defects by 19 European Registries. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 18, 309-316. https://doi.org/10.1046/j.0960-7692.2001.00534.x
[21]
Gonzalez, K.W. and Chandler, N.M. (2019) Ruptured Omphalocele: Diagnosis and Management. Seminars in Pediatric Surgery, 28, 101-105.
[22]
Habtamu, A. and Million, T. (2024) Anterior Abdominal Wall Defects and Their Management Outcomes in Tikur Anbessa Specialized Hospital, Neonatal Intensive Care Unit. JPGN Reports, 5, 433-437. https://doi.org/10.1002/jpr3.12110
[23]
Schimmel, M.S., Bromiker, R., Hammerman, C., Chertman, L., Ioscovich, A., Granovsky-Grisaru, S., Samueloff, A. and Elstein, D. (2015) The Effects of Maternal Age and Parity on Maternal and Neonatal Outcome. Archives of Gynecology and Obstetrics, 291, 793-798.
[24]
Kozuki, N., Lee, A.C., Silveira, M.F., et al. (2013) The Associations of Parity and Maternal Age with Small-For-Gestational-Age, Preterm, and Neonatal and Infant Mortality: A Meta-Analysis. BMC Public Health, 13, Article No. S2. https://doi.org/10.1186/1471-2458-13-S3-S2
