Anterior abdominal wall defects and their management outcomes in Tikur Anbessa Specialized Hospital, neonatal intensive care unit

Abstract

AbstractIntroductionGastroschisis and omphalocele are common malformations of the anterior abdominal wall and can lead to significant morbidity and mortality in neonates. Despite advances in surgical care, these conditions remain challenging to manage effectively.ObjectiveThis retrospective institutional study aimed to assess the management outcomes of neonates with anterior abdominal wall defects, specifically gastroschisis and omphalocele, in the Neonatal Intensive Care Unit (NICU) of Tikur Anbessa Specialized Hospital (TASH) (Tertiary Hospital).MethodA retrospective review was conducted on cases of gastroschisis and omphalocele managed in the NICU of TASH from August 2018 to August 2022. Patient charts of neonates with omphalocele and gastroschisis were identified and retrieved from the NICU records. The collected data were analyzed using statistical software such as SPSS.ResultsThe study included a total of 50 neonates with abdominal wall defects, consisting of 39 cases of omphalocele and 11 cases of gastroschisis. Maternal age ranged from 18 to 40 years, with a mean age of 27.6 ± 4.5 years. Associated malformations were documented in 33.3% of omphalocele cases and 18.2% of gastroschisis cases. Cardiac anomalies were the most frequently associated malformation with omphalocele. Surgical intervention was performed in 27.3% of gastroschisis cases (3 out of 11) and 41% of omphalocele cases (16 out of 39). The postsurgery mortality rate was 12.5% for both major and minor omphaloceles, with 11 deaths occurring in gastroschisis cases. Sepsis was identified as the cause of death in all neonates who did not survive.ConclusionsThe study revealed a significantly higher mortality rate in gastroschisis cases compared to omphalocele cases. Sepsis was identified as the primary cause of death in the neonates. These findings underscore the importance of effective management strategies to prevent and manage sepsis in neonates with abdominal wall defects.