Gastroschisis and Omphalocoele: audit at two referral Hospitals in Johannesburg, South Africa: 2000-2005

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.