Abstract
To characterize and compare the outcomes of omphalocele and gastroschisis from birth to 2 years of follow-up in a recent cohort at a tertiary center. This is a retrospective clinical record review of all patients with gastroschisis and omphalocele admitted to the Neonatal Intensive Care Unit between January 2009 and December 2019. There were 38 patients, 13 of whom had omphalocele, and 25 of whom had gastroschisis. Associated anomalies were present in 6 patients (46.2%) with omphalocele and in 10 (41.7%) patients with gastroschisis. Compared with patients with omphalocele, those with gastroschisis had younger mothers (24.7 versus 29.6 years; p = 0.033), were born earlier (36 versus 37 weeks, p = 0.006), had lower birth weight (2365 ± 430.4 versus 2944.2 ± 571.9 g; p = 0.001), and had a longer hospital stay (24 versus 9 days, p = 0.001). The neonatal survival rate was 92.3% for omphalocele and 91.7% for gastroschisis. Thirty-four patients were followed-up over a median of 24 months; 13 patients with gastroschisis (59.1%) and 8 patients with omphalocele (66.7%) had at least one adverse event, mainly umbilical hernia (27.3% vs 41.7%), intestinal obstruction (31.8% vs 8.3%), or additional surgical interventions (27.3% vs 33.3%). Despite the high proportion of prematurity, low birth weight, and protracted recovery, gastroschisis and omphalocele (without chromosomal abnormalities) may achieve very high survival rates; on the other hand, complications may develop in the first years of life. Thus, a very positive perspective in terms of survival should be transmitted to future parents, but they should also be informed that substantial morbidity may occur in the medium term.
Highlights
Gastroschisis and omphalocele are the most common congenital abdominal wall defects, with a prevalence of $ 2 to 4 per 10,000 live births, respectively.[1]
Despite the high proportion of prematurity, low birth weight, and protracted recovery, gastroschisis and omphalocele may achieve very high survival rates; on the other hand, complications may develop in the first years of life
Trinta e quatro pacientes foram seguidos durante um tempo mediano de seguimento de 24 meses: 13 com gastrosquisis (59.1%) e 8 com onfalocelo (66.7%) apresentaram pelo menos um evento adverso, sobretudo hérnia umbilical (27.3% vs 41.7%), obstrução intestinal (31.8% vs 8.3%) ou intervenções cirúrgicas adicionais (27.3% vs 33.3%)
Summary
Gastroschisis and omphalocele are the most common congenital abdominal wall defects, with a prevalence of $ 2 to 4 per 10,000 live births, respectively.[1] The etiology of these defects remains poorly understood. The prevalence of gastroschisis has been increasing worldwide in recent decades.[1]. Omphalocele is a midline abdominal wall defect in which varying amounts of bowel and liver, and occasionally other organs, protrude through the base of the umbilicus into a membranous sac. Prognosis is determined mainly by the associated anomalies and by the size of the defect and degree of liver exteriorization.[3,4] Omphalocele with co-occurring anomalies, which represents over 60% of cases of omphalocele, is associated with a high rate of pregnancy terminations and intrauterine fetal deaths and a significant rate of mortality in the neonatal period and at 1 year of age.[3,5,6] Infants with isolated omphalocele have the best survival rate.[5,6]
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