Evaluation of the Management of Gastroschisis in Aristide Le Dantec University Hospital Center in Dakar.

Abstract

The management of gastroschisis remains problematic in low- and middle-income countries with high perioperative mortality. The objective of this work was to make an initial assessment of our management of gastroschisis. This was a monocentric and cross-sectional study including all newborns with gastroschisis between January 2017 and December 2021 in the Pediatric Surgery and Anesthesia Resuscitation Department of the Aristide Le Dantec University Hospital Center from Dakar. The socio-demographic, diagnostic, therapeutic and evolutionary parameters were studied. Were collected 18 cases of gastroschisis (11 males and 7 females). The mothers were on average 23.1 ± 5.7 years old. Only one antenatal diagnosis was made. The term of pregnancy was on average 36.5 ± 1.5 weeks. On admission, the mean age was 16.8 ± 6.3 h and the mean weight 2244 ± 260.3 g. Gastroschisis was complex in four patients. Primary bowel reintegration was performed in 8 cases (44.4%) and progressive reintegration using an Applied Alexis retractor in 9 newborns (55.6%). Complications were dominated by respiratory distress (28.3%) and sepsis (22.2%). The mean delay of oral feeding was 5.1 ± 1.9 days. Mortality was 94.4% (17/18). Reducing gastroschisis-related mortality in our low-income countries remains a major challenge.