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

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

doi:10.1007/s00383-020-04638-8

Cited by 15 publications

(12 citation statements)

References 52 publications

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“…This mortality rate in the index study is comparable to the reports of Mayer et al [34]. However, Anyanwu et al reported a mortality of 87% [35]. They documented that this high mortality resulted from hypothermia and sepsis that were present in the neonates before presentation to the hospital.…”

Section: Discussionsupporting

confidence: 78%

Spectrum of Congenital Abdominal Wall Defects in Neonates in a Teaching Hospital in Enugu, Nigeria

Emeka¹

2021

JCSR

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Objective: To evaluate our experience on the pattern and treatment outcome of neonates who presented with congenital abdominal wall defects (CAWD) in a teaching hospital in Enugu, Nigeria. Methodology: This was a retrospective study of neonates who presented with abdominal wall defect of congenital origin between January 2014 and December 2018 at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Results: A total of 236,231 neonates were seen during the study period. Out of this number, 48 neonates had CAWD. This gave a prevalence of 0.02% or 2 babies per 10,000 births. There was male predominance and majority of the neonates were delivered preterm through the vaginal route. Omphalocele and gastroschisis were the most common CAWD and about 50% of the CAWD were diagnosed prenatally through maternal ultrasound. There was a low incidence of associated anomalies and only one-tenth of the mothers gave a history of a possible risk factor. Treatment of CAWD depended on the specific anomaly and sepsis was the most common post-operative complication. Mortality occurred in 8 (16.7%) neonates. Conclusion: Omphalocele and gastroschisis were the most common types of CAWD recorded in the present study. Most of the neonates were delivered vaginally as preterm babies. Treatment was based on the type of CAWD and majority of the neonates survived.

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Section: Discussionsupporting

confidence: 78%

Spectrum of Congenital Abdominal Wall Defects in Neonates in a Teaching Hospital in Enugu, Nigeria

Emeka¹

2021

JCSR

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“…5 This can be attributed to improvements in accurately diagnosing gastroschisis antenatally, monitoring the fetus for complications, and planning for delivery at a facility with paediatric surgeons available. 21 Similar trends have been seen for other congenital anomalies in HICs such as intestinal atresia, CDH, omphalocele, oesophageal atresia and posterior urethral values. By understanding the current role of antenatal ultrasound in LMICs and the barriers to detection, referral and management of structural congenital anomalies, appropriate interventions can be implemented to help improve outcomes.…”

Section: Mirlesse and Ville 118supporting

confidence: 73%

Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review

Goley

Sakula-Barry

Adofo-Ansong³

et al. 2020

bmjpo

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BackgroundCongenital anomalies are the fifth leading cause of under-5 mortality globally. The greatest burden is faced by those in low/middle-income countries (LMICs), where over 95% of deaths occur. Many of these deaths may be preventable through antenatal diagnosis and early intervention. This systematic literature review investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in LMICs.MethodsA systematic literature review was conducted using three search strings: (1) structural congenital anomalies; (2) LMICs; and (3) antenatal diagnosis. The search was conducted on the following databases: Medline, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening was undertaken in duplicate by two reviewers independently. Consensus among the wider authorship was sought for discrepancies. The primary analysis focused on the availability and effectiveness of antenatal ultrasound for diagnosing structural congenital anomalies. Secondary outcomes included neonatal morbidity and mortality, termination rates, referral rates for further antenatal care and training level of the ultrasonographer. Relevant policy data were sought.ResultsThe search produced 4062 articles; 97 were included in the review. The median percentage of women receiving an antenatal ultrasound examination was 50.0% in African studies and 90.7% in Asian studies (range 6.8%–98.8%). Median detection rates were: 16.7% Africa, 34.3% South America, 34.7% Asia and 47.3% Europe (range 0%–100%). The training level of the ultrasound provider may affect detection rates. Four articles compared morbidity and mortality outcomes, with inconclusive results. Significant variations in termination rates were found (0%–98.3%). No articles addressed referral rates.ConclusionAntenatal detection of congenital anomalies remains highly variable across LMICs and is particularly low in sub-Saharan Africa. Further research is required to investigate the role of antenatal diagnosis for improving survival from congenital anomalies in LMICs.PROSPERO registration numberCRD42019105620.

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Section: Onfaloceleunclassified

“…A onfalocele é um defeito da parede abdominal anterior com incidência em torno de 1 a 3/10.000 nascidos vivos e se caracteriza pela cobertura da herniação por uma membrana composta por peritônio e âmnio (24,28). A etiologia da onfalocele é controversa, mas parece estar associada a uma anomalia no fechamento da parede abdominal anterior e ao não retorno do intestino médio para a cavidade celômica no início do primeiro trimestre gestacional (28). Os pacientes portadores de onfalocele apresentam um risco maior do que 50% de apresentarem outras anomalias associadas como por exemplo anomalias genéticas e cardíacas além de um índice de mortalidade perinatal em torno de 37% (29).…”

Section: Onfaloceleunclassified

“…A investigação pré-natal com o uso de ultrassonografia (USG) e a dosagem de α-fetoproteína detectam cerca de 80% dos defeitos da parede abdominal anterior, sendo que a dosagem de α-fetoproteína geralmente aumenta mais na gastrosquise do que na onfalocele (30). A USG pré-natal tem uma acurácia muito alta no diagnóstico da onfalocele, com índices que variam de 83 a 99% dos casos (28). A cirurgia reparadora da onfalocele em geral não precisa ser um procedimento de emergência uma vez que o saco amniótico permanece intacto.…”

Section: Onfaloceleunclassified

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Embriologia da Parede Abominal Aplicada aos Defeitos da Parede Abdominal : Aspectos Translacionais

Favorito¹,

Logsdon²,

Gallo³

et al. 2021

Anais da ANM

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

Cited by 15 publications

References 52 publications

Spectrum of Congenital Abdominal Wall Defects in Neonates in a Teaching Hospital in Enugu, Nigeria

Spectrum of Congenital Abdominal Wall Defects in Neonates in a Teaching Hospital in Enugu, Nigeria

Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review

Embriologia da Parede Abominal Aplicada aos Defeitos da Parede Abdominal : Aspectos Translacionais

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