Rare births, increase in babies born with split abdomen

The country's hospitals are experiencing bizarre cases of babies born with split abdomen, a rare condition known as gastroschisis.

Gastroschisis is a birth defect of the abdominal (belly) wall where a baby's intestines stick outside the body near the belly button. In other cases, other organs like the stomach and liver can also be outside the abdominal cavity.

A surgeon based at Harare Children's Hospital, Dr Bothwell Mbuwayesango, confirmed the cases, but said they were not peculiar to Zimbabwe.

"Although it's rare, it is one of the commonest surgical emergencies in neonates presented to Harare hospital.

"The disease occurs all over the world, it's not unique to Zimbabwe or Africa. However, the incidencies are increasing in the developing world," he explained.

"On average, we treat two to three cases per week. Government hospitals refer such cases to Harare hospital which explains why we experience more cases."

This is with the exception of those in the southern and south-western regions of the country whose cases are refered to Mpilo hospital.

The causes of this disease are not known.

"Nobody knows the cause of the disease but there are certain associated factors. More than two-thirds of the babies born with this condition have teenage mothers and it will be their first pregnancy.

Some of them will also be coming from low socio-economic settings," explained Dr Mbuwayesango.
In Zimbabwe, the survival of children suffering from gastroschisis is between 30 to 40 percent, which is better when compared to other African countries that record zero survival rates in worst cases.

In the developed world, the survival rate is 90 percent.
"Our aim is for every child born with the condition to survive.

"In developed countries, the survival rate is 90 percent while in our own environment survival stands at between 30-40 percent," said Dr Mbuwayesango.

He said surgery must be done within seven hours of birth to increase the chances of survival.
Dr Mbuwayesango stressed that time between birth and treatment is essential for the child's survival.

He hinted that the survival rate for babies born with such conditions could be improved if the critical determinants are treated with caution.

"The most important determinant is the bowel function. Due to the fact that it's exposed, it takes a long time for it to start working normally. Whenever the child is fed, they are likely to vomit hence the required nutrients don't get inside the body, so they die from starvation," he said.

More so, most mothers of the affected babies are afraid to cover the exposed abdomen.

This makes them vulnerable to infections and also results in the baby losing heat and becoming hypothermic (below normal body temperature).