O&G Forum

OBSTETRICS & GYNAECOLOGY FORUM 2022 | ISSUE 3 | 12 well as the perinatal management. 8 e purpose of this study was to correlate sonographic ndings with postnatal clinical outcomes. Methods Inkosi Albert Luthuli Central Hospital (IALCH) serves as the referral centre for both foetal anomaly scanning and paediatric surgery in Kwa-Zulu Natal (KZN). A retrospective analysis was performed of all infants diagnosed with an omphalocoele and gastroschisis between January 2010 and December 2018. Cases were extracted from the IALCH electronic medical record database where all patient diagnoses were captured. Inclusion criteria for the study comprised an ultrasound report with the diagnosis of either gastroschisis or omphalocoele. Exclusion criteria consisted of those patients without an ultrasound report or pre-natal diagnosis as well as stillbirths, termination of pregnancies and babies that died prior to transfer to IALCH. Other types of rare anterior wall defects such as bodystalk anomaly, bladder exstrophy, pentalogy of Cantrell or amniotic band syndrome, were also excluded from the study. A total of 374 patients with AAWD were managed at IALCH between January 2010 andDecember 2018. Only 59 cases of these were eligible for the study. Majority of cases delivered outside of the hospital and were transferred in, hence, ultrasound reports were not available. All infants were managed in the neonatal intensive care unit (NICU) at IALCH by sta neonatologists and paediatric surgeons. Charts were reviewed for maternal demographic data, foetal ultrasound surveillance data, foetal outcome data and neonatal surgical and subsequent outcome data. Statistical analysis was completed using computer so ware (SPSS version 25, SPSS Inc., Chicago, IL, USA). Data was analysed by Chi-square (χ2), paired “t” and Fisher’s exact tests. Data was expressed as "mean (standard deviation; SD)," minimum- maximum 95%CI and percent (%) where appropriate. A p value < 0.05 was considered statistically signi cant. Ethical approval for the study was obtained from the Human Research Ethics Committee (Medical) of the University of KwaZulu Natal. Results As noted above, the data of only 59 cases out of 374 patients with gastroschisis and omphalocoele were reviewed taking into consideration the inclusion criteria for this study. is comprised 25 cases of omphalocoele and 34 cases of gastroschisis. e ratio of omphalocoele to gastroschisis was 1: 1.5. Of the patients included in this study, only one case with an anterior abdominal wall defect was misdiagnosed despite an ultrasound being performed. e case that was misdiagnosed fell into the omphalocoele group and this was assessed as an echogenic cord cyst on prenatal ultrasound. Table 1: Demographic and patient characteristics (n=59). Data are reported as mean ± SD, median and frequencies. Variable Mean ±SD Minimum Maximum 95%CI Age (years) 24.3±7.9 15 43 22.2-26.3 Median 22 Age groups <20 26 (44.06) 20-24 12 (20.3) 25-29 9 (15.2) 30-34 4 (6.7) ≥35 8 (13.5) Ethnicity Black 54 (91.5) Indian 4(6.8) Coloured 1 (1.7) Antenatal care Yes 59 (100) No 0 HIV status Positive 21 (35.6) Negative 38 (64.4) Syphilis Negative 59 (100) Smoking No 59 (100) Alcohol consumption No 59 (100) Type of pregnancy Singleton 56 (94.9) Twin 3 (5.1) Demographic and obstetric characteristics are summarised in Table 1. All infants were live born and there was a slight female preponderance (F:M, 30:29). All patients attended antenatal care with the black population in the majority (91.5%). irteen percent of patients were of advanced maternal age (>35 years of age), whilst 44% were under the age of 20. e HIV prevalence in this study was 35.6% and all patients were screened for syphilis and were negative. ree multiple pregnancies were present in the study sample. Figure 1: Cases of AAWD in KZN divided according to the area of residence 67% 67% 5% 5% 0% 0% 5% 5% 7% 7% 7% 7% 2% 2% 2% 2% 2% 2% 3% 3% 67% 5% 5% 7% 7% 2% 2% 2% 3% O&G Forum 2022; 32: 11-16 ORIGINAL RESEARCH