A Comparative Study of Gastroschisis and Omphalocele Outcomes in Newborns of Buriram Province Between 2011-2020
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Abstract
Background: Gastroschisis and omphalocele are common abdominal wall defects with distinct features. Understanding their differences is essential for appropriate management and counseling.
Objective: To compare clinical characteristics, management, and outcomes of newborns with gastroschisis and omphalocele.
Methodology: A retrospective descriptive study reviewed medical records of newborns diagnosed with gastroschisis or omphalocele from 2011 to 2020 at Buriram Hospital, Thailand. Descriptive statistics, Chi-squared tests, and Mann-Whitney U test were used for analysis.
Results: Total of 53 patients, 43 had gastroschisis and 10 had omphalocele. Mothers of gastroschisis cases were significantly younger (p<0.001). Prenatal diagnosis rates were similar (~30%), with all cases referred for obstetric follow-up. Omphalocele was diagnosed earlier (p=0.043), had more low birth weight (p=0.014), and showed higher rates of patent ductus arteriosus (p<0.01) and Beckwith-Wiedemann syndrome (20%).Gastroschisis was associated with intestinal atresia (7%), perforation (7%), significantly smaller defect size (p<0.001), and no liver herniation. All gastroschisis patients underwent surgery: 81.4% had primary closure, 18.6% staged. In the omphalocele group, only 80% underwent surgery (all with primary closure) while 20% denied surgery. Gastroschisis cases required longer hospital stays (p=<0.001), prolonged parenteral nutrition (p=0.014), and delayed feeding initiation (p<0.001). Postoperative complications differed. Mortality was significantly higher in omphalocele (40% vs. 2.3%, p=0.003).
Conclusion: Despite similar appearance, gastroschisis and omphalocele differ significantly. Gastroschisis demands more intensive postoperative care but has better survival, while omphalocele has higher mortality despite earlier diagnosis and less complex initial management.
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