A retrospective analysis of fetuses diagnosed with anterior abdominal wall defects in a Tertiary Referral South African Hospital Setting

Abstract

Background: Gastroschisis and omphalocoele are the two most common congenital anterior abdominal wall defects.
Complications of these defects can be minimised if a prenatal diagnosis is made by allowing for the opportunity to alter
the mode, location, and timing of delivery and to plan postnatal intervention.
Objectives: A retrospective analysis of fetuses diagnosed with anterior abdominal wall defects in a tertiary referral South
African hospital setting.
Methods: This was a retrospective descriptive study performed at Inkosi Albert Luthuli Central Hospital, Durban from
January 2010 to December 2018. After exclusion criteria, electronic chart review of 59 live born babies diagnosed with
either gastroschisis or omphalocoele was undertaken.
Results: Fifty six singleton pregnancies and 3 twin pregnancies were reviewed comprising 25 cases of omphalocoele
and 34 cases of gastroschisis. In the gastroschisis set liquor abnormalities (38%) and bowel dilatation (50%) were noted
but were not predictive of an adverse outcome. In the omphalocoele group, liquor abnormalities were found in 36% of
cases, of which 44% resulted in mortality. Neonates with gastroschisis remained hospitalised longer than neonates
with an omphalocoele (12 vs 4 days). Although the mortality rate was higher in the omphalocoele compared to the
gastroschisis group, this was not statistically signifi cant (32% vs 14.7%; p value=0.11).
Conclusion: The overall survival of neonates born with gastroschisis was 85% despite longer hospitalisation and
parenteral nutrition compared to infants with omphalocoele (68% survival). With regards to gastroschisis, bowel dilatation
and liquor volume abnormalities were not predictive of adverse outcomes in this study.