Mortality and Morbidity in Babies with Omphalocele Delivered by Normal Vaginal Delivery Versus Cesarean Section in Iraq

Abstract

Background: Omphalocele is a congenital abdominal wall defect associated with significant morbidity and mortality in neonates. The optimal mode of delivery for affected infants remains a subject of clinical debate.

Objective: This study aimed to compare neonatal outcomes between vaginally delivered infants and those delivered via cesarean section (C-section) with omphalocele, hypothesizing that C-section would yield superior clinical results.

Methodology: A comparative retrospective study was conducted on 43 neonates diagnosed with omphalocele at different hospitals in Iraq, over a 12-month follow-up period. The cohort included 23 infants delivered vaginally and 20 delivered via C-section. Outcomes assessed included mortality, morbidity, surgical repair success, hospitalization duration, and feeding progression.

Results: The C-section group demonstrated significantly better outcomes compared to vaginal delivery: lower mortality rate (10% vs. 26.1%).Reduced morbidity, including respiratory distress (40% vs. 65.2%), sepsis (15% vs. 30.4%), and sac rupture (5% vs. 21.7%); shorter hospitalization (40% discharged within 14 days vs. 21.7%); and improved feeding tolerance (70% achieving full oral feeds at discharge vs. 43.5%).

Conclusion: Cesarean delivery is associated with significantly reduced mortality and morbidity in neonates with omphalocele compared to vaginal delivery, where these findings suggest that C-section should be considered the preferred delivery method, particularly for cases involving large defects.