MAJOR ABDOMINAL WALL DEFECTS AND OUTCOME OF MANAGEMENT AT A REFERRAL HOSPITAL.
Background: Gastroschisis and omphalocele are abdominal wall defects that were first described as early as the 16th century. However, it was not until recently that these two conditions were categorized as separate entities. The aim of the study was to determine the occurrence and outcomes of major abdominal wall defects managed at a referral hospital.
Materials and Methods: A retrospective review of omphalocele and gastroschisis managed over 4 years at Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia, from 1 September 2010 to 31 August 2014.
Results: A total of 39 neonates were seen, 24(61.5%) of whom were male (male: female ratio of 1.6:1). Among these, 23(59%) presented with isolated omphalocele, 9(23.1%) with isolated gastroschisis, 6(15.4%) with omphalocele and another anomaly and 1 had gastroschisis with another anomaly. A total of 13 deaths were recorded, with overall fatality rate of 33%. Neonates with omphalocele had significantly better prognosis (20% fatality rate) than neonates with gastroschisis (70% fatality rate). Preterm cases with abdominal wall defect had 50% fatality in contrast to term neonates for whom fatality rate was 31.3%. The observed fatality rate for low birth weight neonates with abdominal wall defect was 56.3% in contrast to 18.2% for normal birth weight neonates. Preterm birth (prematurity), low birth weight and time elapsed before arrival to the tertiary center were significantly associated with poor outcome.
Conclusion: Overall, major abdominal wall defects have high fatality and gastroschisis has a significantly worse outcome than omphalocele.
Key word: Abdominal wall defects, gastroschisis, omphalocele, outcomes
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