Major abdominal wall defects in the low- and middle-income setting: current status and priorities

Lofty-John Chukwuemeka Anyanwu,Udo Rolle,Niyi Ade-Ajayi

doi:10.1007/s00383-020-04638-8

Abstract

Major congenital abdominal wall defects (gastroschisis and omphalocele) may account for up to 21% of emergency neonatal interventions in low- and middle-income countries. In many low- and middle-income countries, the reported mortality of these malformations is 30–100%, while in high-income countries, mortality in infants with major abdominal wall reaches less than 5%. This review highlights the challenges faced in the management of newborns with major congenital abdominal wall defects in the resource-limited setting. Current high-income country best practice is assessed and opportunities for appropriate priority setting and collaborations to improve outcomes are discussed.

Highlights

Congenital anomalies account for 10% of global neonatal deaths, with children in low- and middle-income countries (LMICs) being disproportionately affected [1, 2]
In a retrospective review of 39 patients managed for gastroschisis at the Aminu Kano Teaching Hospital Kano (AKTH), Nigeria (Table 1), over a 5-year period, the median maternal age was 19 years
Newborns should be placed in a sterile plastic bag (Fig. 4) to avoid fluid and temperature loss, which is less than in gastroschisis, but much higher when compared to newborns with an intact abdominal wall

Summary

Introduction

Congenital anomalies account for 10% of global neonatal deaths, with children in low- and middle-income countries (LMICs) being disproportionately affected [1, 2]. Major congenital abdominal wall defects (gastroschisis and omphalocele ) may account for up to 21% of emergency neonatal interventions in the LMIC setting [3, 4]. [6,7,8], while in high-income countries (HICs), mortality in infants with major abdominal wall defects is less than 5% [9, 10].

Results

Conclusion