A case of transdisciplinarity and collaborative decision making: the co-construction of Gendered Food Product Profiles

Crop breeding in sub-Saharan Africa has made considerable gains; however, postharvest and food-related preferences have been overlooked, in addition to how these preferences vary by gender, social difference and context. This context is changing as participatory approaches using intersectional gender and place-based methods are beginning to inform how breeding programmes make decisions. This article presents an innovative methodology to inclusively and democratically prioritise food quality traits of root, tuber and banana crops based on engagement with food systems actors and transdisciplinary collaboration. The outcome of the methodology is the Gendered Food Product Profile (GFPP) - a list of prioritised food quality characteristics - to support breeders to make more socially inclusive decisions on the methods for trait characterisation to select genotypes closer to the needs of food system actors. This article reviews application of the methodology in 14 GFPPs, presents illustrative case studies and lessons learned. Key lessons are that the transdisciplinary structure and the key role of social scientists helped avoid reductionism, supported co-learning, and the creation of GFPPs that represented the diverse interests of food system actors, particularly women, in situ. The method partially addressed power dynamics in multidisciplinary decision making; however, effectiveness was dependent on equitable team relations and supportive institutions committed to valuing plural forms of knowledge. Actions to address power asymmetries that privilege particular types of knowledge and voices in decision making are crucial in techno-science projects, along with opportunities for co-learning and long-term collaboration and a transdisciplinary structure at higher level. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Cassava retting ability and textural attributes of fufu for demand-driven cassava breeding

BACKGROUND

Cassava retting ability and the textural qualities of cooked fufu are important quality traits. Cassava retting is a complex process in which soaking causes tissue breakdown, starch release, and softening. The rate at which various traits linked to it evolve varies greatly during fufu processing. According to the literature, there is no standard approach for determining retting ability. The retting indices and textural properties of fufu were measured using both manual and instrumental approaches.

RESULTS

Different protocols were developed to classify 64 and 11 cassava genotypes into various groups based on retting ability and textural qualities, respectively. The retting protocols revealed considerable genetic dissimilarities in genotype classification: foaming ability and water clarity should be measured at 24 h, while penetrometer, hardness, turbidity, pH, and total titratable acidity data are best collected after 36 h. The stepwise regression model revealed that pH, foaming ability, and dry matter content are the best multivariates (with the highest R2) for predicting cassava retting. These predictors were used to develop an index for assessing the retting ability of cassava genotypes. The retting index developed showed a significant relationship with dry matter content and fufu yield. The study also showed significant correlations between instrumental cohesiveness and sensory smoothness (r = -0.75), moldability (r = -0.62), and stretchability (r = 0.78). Instrumental cohesiveness can correctly estimate fufu smoothness (R2 = 0.56, P = 0.008) and stretchability (R2 = 0.60, P = 0.005).

CONCLUSION

pH, foaming ability, and dry matter content are the best traits for predicting cassava retting ability, while instrumental cohesiveness can effectively estimate fufu smoothness and stretchability. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Gender-inclusive consumer studies improve cassava breeding in Nigeria

Including gender research in cassava breeding makes it easier for farmers to adopt new varieties that meet the specific needs and preferences of both male and female farmers, leading to increased adoption of new varieties, improved productivity, and better economic outcomes for the entire farming community. Gender was included in 2013 in variety development at the National Root Crops Research Institute (NRCRI), Umudike, Nigeria in response to the dis-adoption of some varieties by farmers who had not been part of varietal development from the start, and in light of social roles which influence the responsibilities, resources and livelihood outcomes of men, women and youths. Gender inclusion has given plant breeders accurate information about the cassava traits preferred by all end-users, not just male farmers. At NRCRI, gender studies intensified in the last 5 years, contributing to the development and release of improved varieties. Quantitative and qualitative research by the gender cross-cutting team modeled trait profiling and consumer preferences, to aid demand-led breeding. Some of the methods were acquired at several trainings on how to quantify qualitative responses for prioritization. Gender research techniques include participatory varietal selection (PVS), participatory plant breeding (PPB), mother-baby trials, focus group discussions (FGD), surveys, value chain mapping, G+ tools, experiments in farmer field schools (FFS), demonstration farms, and tricot. These gave the cross-cutting team a better understanding of gender relations, power, decision-making, ownership and control of resources, and have mitigated operational and field challenges during the surveys. These methods also elicited feedback from end-users that led to better naming of newly released varieties, reflecting perceptions of agronomic performance, and food qualities, which made the varieties easier to identify and remember.

Prioritizing preferred traits in the yam value chain in Nigeria: a gender situation analysis

This study describes what did and did not work in the prioritization of preferred traits within the value chain of yam and associated food products (boiled and pounded yam) in Nigeria. Demand-led breeding protocols have enhanced participatory methods along gender lines to increase the clarity of information on the yam traits preferred by farmers and other end users. Drawing on the experience of the cross-cutting gender team at the National Root Crops Research Institute (NRCRI), Umudike, and partners, this study documents the successes and constraints in the use of gender-inclusive approaches for effective breeding. Methods in our gender studies involve critical assessment of the distinction between quantitative and qualitative research, with particular attention to measurement. Various techniques for data collection, such as interviews, observation, and archival studies, are assessed to locate their potential for constructing successful research projects. The methods used include participatory varietal selection, participatory plant breeding, focused discussions with farmer groups, value chain mapping, G+ tools, trait preferences (processing and consumption), triangulation of multi-disciplinary datasets, and social survey research. Yam production in southeast Nigeria is dominated by men, while women are the main processors. Gendered power play, access to resources, and decision-making have been found to constrain women's participation in yam production (and in yam research). Sex disaggregation was applied within the value chain studies to capture the complementarity and differences in the perceptions of women and men. The methods used facilitated the development and release to farmers in 2023 of three improved yam varieties with consumer-preferred characteristics such as high yield, high dry matter content, white tubers, and good boiling and pounding capability. The success stories also show that effective communication and cooperation within the gender cross-cutting team and farmer groups are important for better results. When gender specialists, food scientists, and breeders work together, innovations are created, challenges are overcome, and information is shared.

Varietal impact on women's labour, workload and related drudgery in processing root, tuber and banana crops: focus on cassava in sub-Saharan Africa

Roots, tubers and cooking bananas are bulky and highly perishable. In Africa, except for yams, their consumption is mainly after transport, peeling and cooking in the form of boiled pieces or dough, a few days after harvest. To stabilize and better preserve the products and, in the case of cassava, release toxic cyanogenic glucosides, a range of intermediate products have been developed, mainly for cassava, related to fermentation and drying after numerous processing operations. This review highlights, for the first time, the impact of genotypes on labour requirements, productivity and the associated drudgery in processing operations primarily carried out by women processors. Peeling, soaking/grinding/fermentation, dewatering, sieving and toasting steps were evaluated on a wide range of new hybrids and traditional landraces. The review highlights case studies of gari production from cassava. The results show that, depending on the genotypes used, women's required labour can be more than doubled and even the sum of the weights transported along the process can be up to four times higher for the same quantity of end product. Productivity and loads carried between each processing operation are highly influenced by root shape, ease of peeling, dry matter content and/or fiber content. Productivity and the often related experienced drudgery are key factors to be considered for a better acceptance of new genotypes by actors in the value-addition chain, leading to enhanced adoption and ultimately to improved livelihoods for women processors. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Food Quality Profile of Pounded Yam and Implications For Yam Breeding

BACKGROUND

Assessment of key preferred quality traits in pounded yam, a popularly consumed yam food product in West Africa, is often done through sensory evaluation. Such assessment is time-consuming and results may be biased. Therefore, there is a need to develop objective, high-throughput methods to predict the quality of consumer-preferred traits in pounded yam. This study focused on how key quality traits in pounded yam proposed to yam breeders were determined, measured by biophysical and biochemical methods, in order to shorten the breeding selection cycle through adoption of these methods by breeders.

RESULTS

Consumer tests and sensory quality descriptive analysis (QDA) validated that preferred priority quality traits in pounded yam were related to textural quality: smooth, stretchable, moldable, slightly sticky and moderately hard) and color (white, cream or light yellow). There were significant correlations between sensory textural quality attributes cohesiveness/moldability, hardness, and adhesiveness/stickiness, with textural quality measurements from instrumental texture profile analysis (TPA). Color measurement with chromameter (L*, a*, and b*) parameters agreed with that of sensory evaluation and can replace the sensory panel approach. The smoothness (R² =1.00), stickiness (R² =1.00), stretchability (R² =1.00), hardness (R² =0.99), and moldability (R² = 0.53) of pounded yam samples can be predicted by the starch, amylose, and protein contents of yam tubers estimated by near-infrared spectroscopy.

CONCLUSION

TPA and Hunter colorimeter can be used as medium-high throughput methods to evaluate the textural quality and color of pounded yam in place of the sensory panelists. This article is protected by copyright. All rights reserved.

Characterizing quality traits of boiled yam: texture and taste for enhanced breeding efficiency and impact

BACKGROUND

Boiled yam key quality attributes typical for West African consumers are that it is crumbly, easy to break and has a sweet taste. New yam varieties are being developed but high- or medium-throughput tools to assess the required quality traits and their range of acceptance are limited. This study assessed the acceptance thresholds of these quality attributes and established predictive models for screening yam varieties that meet the required consumer preferences.

RESULTS

Overall liking was associated with sweet taste, crumbliness and easiness to break (r-values 0.502, 0.291 and -0.087, respectively). These parameters and selected biophysical parameters highly discriminated the boiled yam varieties. Crumbly texture and easiness to break were well predicted by penetration force and dry matter, whereas sweet taste were well predicted by dry matter and sugar intensity. A high crumbliness and sweet taste are preferred (sensory scores above 6.19 and 6.22 for crumbly and sweet taste, respectively, on a 10 cm unstructured line scale), while a too high easiness to break is disliked (sensory scores ranging from 4.72 to 7.62). Desirable biophysical targets were between 5.1 and 7.1 N for penetration force, dry matter around 39% and sugar intensity below 3.62 g 100 g^-1 . Some improved varieties fulfilled the acceptable thresholds, and screening was improved through deviation from the optimum.

CONCLUSION

Acceptance thresholds and deviation from optimum for boiled yam assessed through the instrumental measurements are promising tools for yam breeders. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Establishing the linkage between eba's instrumental and sensory descriptive profiles and their correlation with consumer preferences: implications for cassava breeding

BACKGROUND

Gari and eba, forms of cassava semolina, are mainly consumed in Nigeria and other West African countries. This study aimed to define the critical quality traits of gari and eba, to measure their heritability, to define medium and high throughput instrumental methods for use by breeders, and to link the traits with consumer preferences. The definition of a food product's profiles, including its biophysical, sensory, and textural qualities, and the identification of the characteristics that determine its acceptability, are important if new genotypes are to be adopted successfully.

RESULTS

Eighty cassava genotypes and varieties (three different sets) from the International Institute of Tropical Agriculture (IITA) research farm were used for the study. Participatory processing and consumer testing data on different types of gari and eba products were integrated to prioritize the traits preferred by processors and consumers. The color, sensory, and instrumental textural properties of these products were determined using standard analytical methods, and standard operating protocols (SOPs) developed by the RTBfoods project (Breeding Roots, Tubers, and Banana Products for End-user Preferences, https://rtbfoods.cirad.fr). There were significant (P < 0.05) correlations between instrumental hardness and sensory hardness and between adhesiveness and sensory moldability. Principal component analysis showed broad discrimination amongst the cassava genotypes and the association of the genotypes concerning the color and textural properties.

CONCLUSIONS

The color properties of gari and eba, together with instrumental measures of hardness and cohesiveness, are important quantitative discriminants of cassava genotypes. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Beyond “Women's Traits”: Exploring How Gender, Social Difference, and Household Characteristics Influence Trait Preferences

Demand-led breeding strategies are gaining importance in public sector breeding globally. While borrowing approaches from the private sector, public sector programs remain mainly focused on food security and social impact related outcomes. This necessitates information on specific user groups and their preferences to build targeted customer and product profiles for informed breeding decisions. A variety of studies have identified gendered trait preferences, but do not systematically analyze differences related to or interactions of gender with other social dimensions, household characteristics, and geographic factors. This study integrates 1000minds survey trait trade-off analysis with the Rural Household Multi-Indicator Survey to study cassava trait preferences in Nigeria related to a major food product, gari. Results build on earlier research demonstrating that women prioritize food product quality traits while men prioritize agronomic traits. We show that food product quality traits are more important for members from food insecure households and gender differences between men and women increase among the food insecure. Furthermore, respondents from poorer households prioritize traits similar to respondents in non-poor households but there are notable trait differences between men and women in poor households. Women in female headed household prioritized quality traits more than women living with a spouse. Important regional differences in trait preferences were also observed. In the South East region, where household use of cassava is important, and connection to larger markets is less developed, quality traits and in ground storability were prioritized more than in other states. These results reinforce the importance of recognizing social difference and the heterogeneity among men and women, and how individual and household characteristics interact to reveal trait preference variability. This information can inform trait prioritization and guide development of breeding products that have higher social impact, which may ultimately serve the more vulnerable and align with development goals.

Quality attributes of fufu in South-East Nigeria: guide for cassava breeders

Fufu is a popular traditional fermented wet paste food product from cassava. We examined consumer preferences and quality attributes of fufu in Abia and Imo States of South-East Nigeria, with special attention to gender differences, for the purpose of providing guidance to breeders. Data were analysed by the use of descriptive and inferential statistics. Participants for the interview were randomly selected from a list of farmers in the study area. Individual (II) interviews were conducted among eighty participants comprising twenty-six men (32.5%) and fifty-four women (67.5%). Preferences along the food chain from raw roots to final product were also obtained. Major traits influencing gender-specific consumer preferences are related to appearance, texture and smell. Smoothness, not sticky, easy to swallow and drawability of fufu appear to be major traits that drive acceptance by both men and women. Big roots and smooth skin are prioritised for raw material. Some quality characteristics are conditioned largely by variety traits, while others can be modified by adjusting the processing methods. The complexity of producing high-quality fufu makes it imperative to introduce a multidisciplinary approach into breeding programmes.

End-user preferences for pounded yam and implications for food product profile development

Pounded yam is a popular food in Nigeria. This study reports end-user preferences for pounded yam and implications for trait evaluation by breeding programme. The study was carried out in two pounded yam-consuming regions in Nigeria: south-east and south-west. Multistage sampling technique was used to collect information from users along food chain. This involved market, individual, key informant interviews and focus group discussions. Responses of participants were used to develop product profile of pounded yam from raw material (yam) to final product. Key user-preferred quality traits for pounded yam in both regions were colour and textural quality followed by taste and aroma which are lesser attributes. There were regional differences in ranking of these quality attributes but no gender difference. This information will be useful in determining food quality indicators that can be used to select breeding lines for preferred quality traits in pounded yam.

Understanding cassava varietal preferences through pairwise ranking of gari-eba and fufu prepared by local farmer-processors

Within communities in Osun and Imo States of Nigeria, farmer-processors grew and processed a diverse set of improved and landrace cassava varieties into the locally popular foods, gari, eba and fufu. Local and 15 main varieties were grown in a 'mother and baby trials' design in each state. Mother trials with three replications were processed by farmer-processors renown in their community for their processing skills. Baby trials were managed and processed by other farmer-processors. The objective was to identify food quality criteria to inform demand-led breeding to benefit users, especially women, given their key roles in processing. Farmer-processors evaluated the overall quality of fresh roots and derived food products through pairwise comparisons. Improved varieties had higher fresh and dry root yield. Overall, landraces ranked first for quality of gari and eba, but several improved varieties were also appreciated for good quality. Landraces in Osun had higher gari yield and a higher swelling power compared to improved varieties. Colour (browning), bulk density, swelling power, solubility and water absorption capacity were the criteria most related to food product ranking by farmer-processors. Evaluation of varieties under farmer-processors' conditions is crucial for providing guidance to breeders on critical selection criteria.

From cassava to gari: mapping of quality characteristics and end-user preferences in Cameroon and Nigeria

User's preferences of cassava and cassava products along the value chain are supported by specific root quality characteristics that can be linked to root traits. Therefore, providing an evidence base of user preferred characteristics along the value chain can help in the functional choice of cassava varieties. In this respect, the present paper presents the results from focus group discussions and individual interviews on user preferred quality characteristics of raw cassava roots and the derived product, gari, - one of the major cassava products in Sub-Saharan Africa - in major production and consumption areas of Cameroon and Nigeria. Choice of cassava varieties for farming is mainly determined by the multiple end uses of the roots, their agricultural yield and the processing determinants of roots that support their major high-quality characteristics: size, density, low water content, maturity, colour and safety. Processing of cassava roots into gari goes through different technological variants leading to a gari whose high-quality characteristics are dryness, colour, shiny/attractive appearance, uniform granules and taste. Eba, the major consumption form of gari in Cameroon and Nigeria, is mainly characterised by its textural properties: smoothness, firmness, stickiness, elasticity and mouldability. Recommendations are made, suggesting that breeding will have to start evaluating cassava clones for brightness/shininess, as well as textural properties such as mouldability and elasticity of cassava food products, for the purpose of supporting decision-making by breeders and the development of high-throughput selection methods of cassava varieties. Women are identified as important beneficiaries of such initiatives giving their disadvantaged position and their prominent role in cassava processing and marketing of gari.

The need for Paediatric Emergency Laparotomy Audit (PELA) in the UK

INTRODUCTION

The National Emergency Laparotomy Audit (NELA) has raised serious concerns about the processes of care and outcomes in adult emergency laparotomies in the UK. To date, no comparable data have been published for children. The aim of this study was to investigate the need for a similar audit in children.

METHODS

Data were collected retrospectively following NELA guidelines. Results were analysed using QuickCalcs (GraphPad Software, La Jolla, CA, US).

RESULTS

The study period spanned 7.5 years. A total of 161 patients were identified for inclusion in the audit. The median patient age was 2.8 years. Half (49%) of the cohort were deemed ASA (American Society of Anesthesiologists) grade ≥2. A history of previous abdominal surgery was noted in 37% of the patients. The median time from admission to operation was 15 hours. Over a third (39%) of the operations were performed out of hours. The most common indications for surgery comprised adhesive bowel obstruction (37%), intussusception (27%) and volvulus (9%).The median length of hospital stay was 8 days with the median postoperative stay being 6 days (NELA data 10.6 days). Half (51%) of the cases required intensive care following surgery. The 30-day mortality rate was 3.1%. The overall mortality rate was 4.3% (NELA data 16%). Patient care was led by a consultant surgeon in 100% of cases (NELA data 89%).

CONCLUSIONS

This is the first study in children that provides baseline data about the standards of care and outcomes from a single centre paediatric emergency laparotomy audit. A larger study using data from multiple centres would be of great benefit.

Thirty-days readmissions in pediatric surgery: The first U.K. experience

INTRODUCTION

The aim of this study was to investigate readmissions within 30days of operation (ReAd) in the setting of a tertiary pediatric surgical practice in the UK.

METHODS

Using Hospital Episode Statistics, cases that were readmitted within 30days of primary operation were identified retrospectively. Demographics including age, gender, preexisting comorbidities, diagnosis on primary admission and the treatment, length of stay, and diagnosis on readmission with treatment, including further surgical intervention, were collected from discharge summaries and hospital notes. Neonates were excluded from this study. Comorbidities, involving one or more systems, were also identified for each case of readmission. ReAds were classified into emergency and elective cohort depending on the nature of the primary operation. Outcomes were compared between these two groups. Data were quoted as median (range) unless indicated otherwise. Data were analyzed using SPSS software Desktop 22.0, using Mann-Whitney U and Chi-Squared tests, with a consideration that a P≤0.05 was significant.

RESULTS

A total of 2378 procedures were performed during the study period. Elective cases, including day cases, accounted for 77% (n=1837) of all cases. The remaining 23% (n=541) were emergency cases. Total unplanned readmission rate within 30days (ReAd) was 2%. Further surgical procedures were required in 38%. Having excluded neonates, the most common primary procedure leading to readmission within 30days was appendicectomy (26%). Overall, the most common cause for readmission within 30days was postoperative infection (30%). The ReAd in emergency cohort was 3.5% in comparison to 1.5% in elective, which was significantly different (P value=0.007).

CONCLUSION

Readmission within thirty days of primary procedure in pediatric surgery has little published data. An efficient discharge planning may play a vital role in preventing unwanted readmission. Elective operations had a significantly lower readmission rate than emergency operations. Having excluded neonates, appendicectomy was found to be the most common operation associated with readmission in the pediatric surgical practice. Although widely used as quality care indicator in adults, more studies are required to validate readmission rate as a quality of care indicator in pediatric surgery practice.

Prenatal ultrasound in the prediction of bowel obstruction in infants with gastroschisis

OBJECTIVE

To assess the value of prenatal ultrasound in predicting bowel obstruction requiring surgery in fetuses with prenatal diagnosis of gastroschisis.

METHODS

The database of our center was searched for cases with an antenatal diagnosis of gastroschisis. The ultrasound images were reviewed blindly to assess the presence of intra- or extra-abdominal bowel dilatation. Details of surgical procedures were noted and the discharge letters were obtained. Pediatric follow-up was also obtained from pediatric surgeons, general practitioners or parents.

RESULTS

In the 10-year period between November 1998 and September 2008 there were 62 cases with a prenatal diagnosis of gastroschisis. Postnatal outcome was not available for five cases, four pregnancies underwent termination and intrauterine fetal demise occurred in five cases. A final population of 48 liveborn infants was available for analysis. Intra-abdominal bowel dilatation was identified in 14 of these 48 fetuses (29.2%) and extra-abdominal bowel dilatation in 30 (62.5%) fetuses on prenatal ultrasound images. Eight fetuses (16.7%) had bowel obstruction. The relative risk of bowel obstruction with intra-abdominal bowel dilatation was 4.05 (95% CI, 1.12-14.70). On the other hand, the relative risk of bowel obstruction with extra-abdominal bowel dilatation was 1.0 (95% CI, 0.37-3.70). Four babies died, two of whom had intra- and one had extra-abdominal bowel dilatation.

CONCLUSIONS

Intra-abdominal dilatation of the bowel on prenatal ultrasound examination appears to predict postnatal bowel obstruction and the need for surgical resection. Extra-abdominal bowel dilatation is observed frequently on prenatal ultrasound scans, but is not predictive of bowel obstruction.

Early high C-reactive protein in infants with open abdominal wall defects does not predict sepsis or adverse outcome

AIM

To study CRP values and relate it to outcome in infants with antenatal diagnosis of gastroschisis, exomphalos and other surgical conditions.

METHODS

Over five years, infants admitted to our neonatal unit with gastroschisis, exomphalos and other surgical diagnoses were identified. Serum CRP measurements in first 5 days were studied. Group one included 33 gastroschisis patients, group two, 18 exomphalos patients, and group three, 38 patients with other surgical diagnoses. Outcome measures included TPN days, time to full feeds and duration of hospitalization.

RESULTS

Infants with gastroschisis were more premature (36.9 vs 38.1 weeks) with lower birth weights (2515 vs 3078 g), than infants with exomphalos. CRP values on admission in gastroschisis group were significantly higher than exomphalos and other diagnoses groups (33.7 +/- 6.4 vs 8.8 +/- 6.0 vs 5.7 +/- 2.0, respectively, p < 0.05). All blood cultures were sterile. There was no relationship between high CRP and death or adverse outcome (TPN days, time to full feeds or duration of hospitalization) in the gastroschisis group.

CONCLUSION

Infants with gastroschisis exhibit high early CRP, which may not indicate sepsis or adverse outcome. This increase can complicate the assessment of these infants. Clinicians should be aware of this finding as it could inform management decisions in this group.

Outcome of antenatally diagnosed abdominal wall defects

OBJECTIVE

To examine the natural history and detailed outcome of antenatally diagnosed abdominal wall defects.

METHODS

This was a retrospective review of the antenatal reports, pediatric surgery records and subsequent follow-up information of all cases of omphalocele and gastroschisis diagnosed in a 10-year period in our tertiary referral center.

RESULTS

There were 109 cases of abdominal wall defects, including omphalocele in 67 cases and gastroschisis in 42 cases. Of the 67 cases of omphalocele there were 26 (39%) with chromosomal abnormalities and 22 (33%) underwent termination of pregnancy, mainly for associated structural abnormalities. Of the ongoing 19 cases there were five (26%) in-utero deaths, 12 (63%) survivors and two (11%) neonatal deaths, both associated with prematurity. Excluding chromosomal abnormalities, the survival rate in isolated omphalocele was 7/16 (44%) whilst it was 5/25 (20%) in those with associated abnormalities. Gastroschisis was isolated in 40 (95%) cases. Among these 40 isolated cases there were two (5%) terminations. Of the 38 ongoing cases, there were two (5%) in-utero deaths, and 36 (95%) live births. Four of the 36 liveborn infants (11%) died in the postoperative period owing to complications of small bowel atresia.

CONCLUSIONS

Although only 18% of infants with antenatally diagnosed omphalocele were alive in the neonatal period, postoperative morbidity was low. The majority (90%) of fetuses with antenatally diagnosed gastroschisis survived to delivery, but the mortality in affected newborns was 11%.