Omphalocele: 15-years experience from a single center in developing country

Abstract

Background: Omphalocele is one of the most common anterior abdominal wall defects and still remains a management challenge in developing countries. A multidisciplinary team approach involving various prenatal and postnatal interventions is required to have a favorable outcome. In this study, we had analyzed the clinical profile and outcome of the neonates with omphalocele in a developing country. Materials and Methods: We had done a retrospective analysis of medical records of neonates who were admitted with omphalocele at our center from 2002 to 2016. Results: A total of 65 neonates were enrolled in the study with a male-to-female ratio of 1.6:1. Mean birth weight was 2550 ± 670 g and mean gestational age was 37.2 ± 3.4 weeks. Polyhydramnios was present in 40% pregnancies and only 30% (20/65) were diagnosed on prenatal ultrasound screening. Nearly 31 neonates (48%) were having omphalocele minor, and 34 (52%) were diagnosed with omphalocele major. The incidence of associated anomalies was 40% (26/65) with cardiac diseases being the most common followed by gut anomalies. Primary closure of defect was done in 78.5% (51/65) neonates, and delayed surgical repair was performed in 21.5% (14/65) neonates. Mean duration of postoperative hospital stay was 15.5 ± 3.5 days. Five patients (7.6%) expired during study period including two with associated congenital anomalies and one with rupture of omphalocele major sac membrane. Conclusion: Despite significant improvements, management of omphalocele still poses a challenge due to variable size of the defect and associated anomalies. Whenever feasible, early primary surgical repair remains the ideal procedure to have a good outcome.