Department of Paediatric Surgery, Walter Sisulu University, Mthatha, South Africa.
Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
Afr J Paediatr Surg. 2023 Jan-Mar;20(1):46-50. doi: 10.4103/ajps.ajps_178_21.
Gastroschisis is a common abdominal wall defect faced by paediatric surgeons worldwide. Early gastroschisis detection, access to improved neonatal intensive care, parenteral nutrition and surgical techniques have led to a reported improvement in mortality of between 4% and 8% in high-income countries. In low to middle income countries, such as in Southern Africa, however, there is as much as 84% mortality among patients with gastroschisis. This is thought to be due to factors such as lack of antenatal screening, access to neonatal intensive care services and parenteral nutrition.
The purpose of this study was to calculate the prevalence of gastroschisis and report on its neonatal mortality in the Eastern Cape Province of South Africa.
A retrospective observational study on all neonates with gastroschisis, presenting to a tertiary facility offering paediatric surgical services within the Eastern Cape Province from 1 January 2016 to 31 December 2018.
A convenience sampling method was used in retrieving patient files for the study period. Statistical analysis used: Stata version 13.
Thirty-seven neonates were included in the study. The prevalence of gastroschisis ranged from 0.07% to 0.18% throughout the 3-year study. The majority (81%) of the neonates were outborn and delivered by mode of caesarean section. Nearly 60% (n = 22) were female. 54% (n = 20) of neonates died within the neonatal period.
The majority of the neonates in this study were outborn and female. Although their mortality rate was higher than reported in high-income countries, it was much improved from what is reported in the low to middle income countries.
腹裂是全世界小儿外科医生面临的一种常见腹壁缺陷。在高收入国家，早期腹裂的检测、获得更好的新生儿重症监护、肠外营养和手术技术，使得死亡率报告降低了 4%至 8%。然而，在南非等中低收入国家，腹裂患儿的死亡率高达 84%。这被认为是由于缺乏产前筛查、获得新生儿重症监护服务和肠外营养等因素所致。
本研究旨在计算南非东开普省腹裂的患病率，并报告其新生儿死亡率。
这是一项回顾性观察研究，纳入了 2016 年 1 月 1 日至 2018 年 12 月 31 日期间在东开普省提供小儿外科服务的三级医疗机构就诊的所有腹裂新生儿。
采用方便抽样法检索研究期间的患者病历。统计分析采用 Stata 版本 13。
研究共纳入 37 例新生儿。在 3 年的研究期间，腹裂的患病率在 0.07%至 0.18%之间。大多数（81%）新生儿为外地产儿，经剖宫产分娩。近 60%（n=22）为女性。54%（n=20）的新生儿在新生儿期死亡。
本研究中的大多数新生儿为外地产儿，且为女性。尽管其死亡率高于高收入国家报告的死亡率，但与中低收入国家报告的死亡率相比，已有显著改善。
