Gastroschisis: Bellwether for neonatal surgery capacity in low resource settings?

Ford, Kat; Poenaru, Dan; Moulot, OlivierMartial; Tavener, K; Bradley, Sarah; Bankolé, R; Tshifularo, N.; Ameh, Emmanuel A.; Alema, Nelson; Borgstein, Eric; Hickey, Ann; Ade-Ajayi, Niyi

doi:10.1016/j.jpedsurg.2016.02.090

Cited by 51 publications

(44 citation statements)

References 28 publications

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“…All the patients were born outside the hospital; 21 (53.8%) were septic and all were hypothermic at presentation. Earlier studies from our sub-region had shown that septicaemia and hypothermia were common causes of death in infants with gastroschisis [6,8,10]. Analysis of certain patient-related variables in this series, however, did not show any that was significantly associated with mortality (Table 4).…”

Section: Treatment Outcomecontrasting

confidence: 60%

“…simple (without intestinal pathology) and complex (with intestinal pathology), to aid the comparison of outcome between series and the categorization of risk, and this has been adopted by many [9,21,[28][29][30]. Given that the causes of death in infants with GS are diverse [10,27,31], the capacity of a particular centre to address the various aspects of the compromised neonate with gastroschisis will impact on their outcome. Ford et al had demonstrated that avertable DALYs (or unmet need) in the management of neonates with GS were lowest in HICs and highest in low-income countries (LICs).…”

Section: Treatment Outcomementioning

confidence: 99%

“…Ford et al had demonstrated that avertable DALYs (or unmet need) in the management of neonates with GS were lowest in HICs and highest in low-income countries (LICs). They concluded that GS outcomes for any particular unit are a useful barometer of the capacity of that unit to deliver generic neonatal surgical care [10]. Mortality in the AKTH Kano series was 87.2% (34/39).…”

Section: Treatment Outcomementioning

confidence: 99%

“…This may be exacerbated by suboptimal neonatal transportation to the appropriate health facility. In many LMICs, the reported mortality is 30-100% [6][7][8], while in high-income countries (HICs), mortality in infants with major abdominal wall defects is less than 5% [9,10].…”

Section: Introductionmentioning

confidence: 99%

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

2020

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Major congenital abdominal wall defects (gastroschisis and omphalocele) may account for up to 21% of emergency neonatal interventions in low-and middle-income countries. In many low-and middle-income countries, the reported mortality of these malformations is 30-100%, while in high-income countries, mortality in infants with major abdominal wall reaches less than 5%. This review highlights the challenges faced in the management of newborns with major congenital abdominal wall defects in the resource-limited setting. Current high-income country best practice is assessed and opportunities for appropriate priority setting and collaborations to improve outcomes are discussed.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Treatment Outcomecontrasting

confidence: 60%

Section: Treatment Outcomementioning

confidence: 99%

Section: Treatment Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

2020

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“…Sepsis is a major culprit in most cases of neonatal mortality in LMICs [48]. The Gastroschisis International (GiT) network has suggested that poor resuscitation combined with sepsis and abdominal compartment syndrome is directly linked to the poor outcome [50].…”

Section: Gs In Low To Middle Income Countries (Lmics)mentioning

confidence: 99%

Management of Gastroschisis

Obeida¹,

Shalaby²

2019

Pediatric Surgery, Flowcharts and Clinical Algorithms

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Gastroschisis (GS) is one of the congenital abdominal wall defects, in which the bowel has prolapsed without a covering through a defect adjacent to (and nearly always to the right of) an otherwise normal umbilicus. Proper management of such cases gives them the opportunity to survive and thrive. In this chapter, simplified flowcharts for the initial management of GS, surgical intra-operative decisions and post-operative active follow-up of such cases will be presented and discussed. The first flowchart will discuss how to deal with a GS case from birth till the operative theatre, while the second flowchart will take the lead to guide the surgeon with the available surgical options and how to choose the suitable one for the case. Finally, the post-operative active follow-up fluid management and possible complications are discussed.

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The Heterogeneity of Global Pediatric Surgery: Defining Needs and Opportunities Around the World

et al. 2018

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Background The global burden of pediatric surgical conditions continues to remain inadequately addressed, particularly in low‐ and middle‐income countries. Among the many factors contributing to this gap are a lack of access to care secondary to resource shortages and inequitable distribution, underfinancing of healthcare systems, poor quality of care, and contextual challenges such as natural disasters and conflict. The relative contribution of these and other factors varies widely by region and even with countries of a region. Methods This review seeks to discuss the heterogeneity of global pediatric surgery and offer recommendations for addressing the barriers to high‐quality pediatric surgical care throughout the world. Results There is significant heterogeneity in pediatric surgical challenges, both between regions and among countries in the same region, although data are limited. This heterogeneity can reflect differences in demographics, epidemiology, geography, income level, health spending, historical health policies, and cultural practices, among others. Conclusion Country‐level research and stakeholder engagement are needed to better understand the heterogeneity of local needs and drive policy changes that contribute to sustainable reforms. Key to these efforts will be improved financing, access to and quality of pediatric surgical care.

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Gastroschisis: Bellwether for neonatal surgery capacity in low resource settings?

Cited by 51 publications

References 28 publications

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

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

Management of Gastroschisis

The Heterogeneity of Global Pediatric Surgery: Defining Needs and Opportunities Around the World

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