Prevalence, Outcome and Pattern of Congenital Anterior Abdominal Wall Defects Among Neonates at BMC. - Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2024. - 38 Pages Includes References

Background information:

Development during pregnancy can be classified as either normal or pathological. When environmental influences or genetic abnormalities interfere with normal development at the crucial stage of embryogenesis, it can lead to abnormal development. Alternatively, it might be the result of both. These elements may cause aberrant histogenesis, morphogenesis, and cytogenesis, which would result in a newborn with a deficiency(1, 2). A congenital anomaly (CA) is a structural and functional aberration that manifests at birth and is sometimes referred to as a birth defect (BD). BD can be described in terms of four clinically significant types based on the causes, timing, and extent of the developmental interference during prenatal life by teratologic agents. These include dysplasia, deformity, disruption, and malformation(3, 4). According to estimates from the World Health Organization (WHO), BDs were responsible for over 260,000 fatalities worldwide in 2004 (or 7% of all newborn deaths)(5). The prevalence rates of BDs are thought to be 4.7% in affluent nations, 5.6% in middle-income nations, and 6.4% in low-income nations(6). In a study by Shitaye et al. it was revealed that 61.5% of whom were male (male: female ratio of 1.6:1). Among these, 59% presented with isolated omphalocele, 23.1% with isolated gastroschisis, 15.4% with omphalocele and another anomaly and 1 had gastroschisis with another anomaly. A total of 13 deaths were recorded, with overall fatality rate of 33%. Neonates with omphalocele had significantly better prognosis (20% fatality rate) than neonates with gastroschisis (70% fatality rate). Preterm cases with abdominal wall defect had 50% fatality in contrast to term neonates for whom fatality rate was 31.3%(7). Mohamed et al. reported that The most common observed defect was gastroschisis, Mortality was generally high among children presenting with gastroschisis. Complex gastroschisis has a poorer prognosis than simple gastroschisis over 30 days follow up period. Non-use of antibiotics before referral to a health facility and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period(8). Berdawd et al revealed that Omphalocele cases were more likely to have associated congenital anomalies and gastroschisis, if the associated anomalies were confined to the gastrointestinal tract. There was a high mortality rate, especially in patients with gastroschisis and ruptured omphalocele due to a lack of intensive care units, facilities, and trained personnel to look after such high-risk patients(9). Gamba et al. reported at present times, closure of defects, even in multiple stages, is always possible as well as management of most of cardiac-, urinary-, and gastrointestinal-associated malformations. The progress, herein discussed, in the care of newborns with abdominal wall defects assures most of them survive and reach adulthood(10). In a study by Dingemann et al Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele(11). Kapapa et al reported that there is an increased risk for GS if several factors such as young maternal age, short cohabitation time, and usage of antibiotics coincide with alcohol consumption and associated immune diseases. OC increased after hormonal treatment and invasive prenatal diagnostics(12). This study in aimed at determining the prevalence, outcome and pattern of congenital abdominal wall defects among neonates at BMC. Understanding the prevalence and patterns may contribute to the development of preventive measures. This could involve identifying risk factors during pregnancy and implementing strategies to reduce the incidence of congenital abdominal wall defects.


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Subjects--Personal Names: --Paediatrics and Child Health--Parasitology and Entomology