Gastroschisis and Omphalocoele: audit at two referral Hospitals in Johannesburg, South Africa: 2000-2005
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Date
2011-11-23
Authors
Beckh-Arnold, Elaine Mary Philippa
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Abstract
Gastroschisis and omphalocoele are serious birth defects which differ in many aspects.
There are numerous reports of an increase in the incidence of gastroschisis but not
omphalocoele.
A retrospective analysis was conducted including all infants with gastroschisis and
omphalocoele admitted to two tertiary institutions in Johannesburg over six years from
2000-2005. The study aimed to describe the frequency of gastroschisis and
omphalocoele, assess maternal characteristics, evaluate clinical details and factors that
may affect mortality, describe additional abnormalities and determine if there was
appropriate use of genetic services.
The prevalence of gastroschisis and omphalocoele was 0.36 per 1 000 live births and
between the years 2000 and 2005, there was a 2.7 fold increase in the number of patients
with gastroschisis compared to omphalocoele. Sixty percent of the patients were
transferred into the hospitals and 47% of these patients demised. Twenty-one percent
(3/14) of patients with additional abnormalities were referred for a genetic assessment.
Fifty-eight percent (7/12) of patients with omphalocoele and additional congenital
abnormalities demised. Fifty-eight percent (7/12) of the patients with sepsis demised.
From this study, improvement in certain areas such as prenatal diagnosis, interhospital
transfer and education of staff involved in the care of patients with gastroschisis and
omphalocoele is recommended to facilitate a reduction in the high mortality observed.