Characteristics and Outcome and the Omphalocele Circumference/Abdominal Circumference Ratio in Prenatally Diagnosed Fetal Omphalocele

Abstract

Objective: To evaluate the outcome of fetuses with prenatally diagnosed omphalocele and to investigate the predictive value of the omphalocele circumference/abdominal circumference (OC/AC) ratio – a measure for the relative size of the omphalocele. Materials and Methods: This study includes all fetuses prenatally diagnosed with omphalocele at our centre between 1995 and 2007. Medical records and footage of ultrasound examinations were reviewed. Omphalocele was classified in four groups: isolated, chromosomal, syndromic, and multiple anomalies. Results: Eighty-eight cases were identified: 21 (24%) were isolated and 67 had additional structural anomalies. Of the 44 fetuses (50%) with chromosomal anomalies, 2 had omphalocele as a solitary finding. Fifty-three pregnancies (60%) were terminated because of the size of the lesion or associated structural or chromosomal anomalies. Twenty-one cases resulted in a live birth, of which 17 were vaginal deliveries (81%, all uncomplicated) including 3 cases of giant omphalocele (≧5 cm). The OC/AC ratio was found predictive for herniation of the liver, respiratory insufficiency and type of surgical reconstruction. Currently, 12/88 fetuses (14%) are alive and well, including 2 infants with multiple anomalies. Conclusion: Identification of omphalocele should arouse suspicion of genetic abnormalities, even in cases that appear isolated. The OC/AC ratio may influence counselling regarding the postnatal course.

Gender-Dependent Effect of ACE I/D and AGT M235T Polymorphisms on the Progression of Urinary Albumin Excretion in Taiwanese with Type 2 Diabetes

“…Two reports have, however, studied the gender-specific effect of M235T polymorphism and DN, and found an association between the T allele and risk of DN in men only [38, 39]. Those studies proposed that TT genotype by itself was not sufficient to increase the susceptibility to DN and that the high blood pressure (defined as SBP 160 or DBP 95 mm Hg) of the men in their studies may have contributed to the deterioration in renal function [38, 39]. In our study, the mean level of SBP and DBP was less than 130/80 mm Hg in both sexes.…”

Prenatally diagnosed fetal omphalocele at 11 week gestation — a case report

“…If omphalocela exists independently, if it is not associated with genetic or chromosomal syndromes, regular ultrasound scans can investigate the predictive value of omphalocele circumference/abdominal circumference (OC/AC) ratio -a measure for the relative size of the omphalocele in order to avoid perinatal complications and to decide of the time and the manner and of delivery [14]. In our case, this ratio was 0.9.…”

Neonatal Outcome of Abdominal Wall Defects at a Tertiary Center in Oman

“…However, in a recent study by Kleinrouweler, et al 17 of 21 (81%) infants were delivered via vaginal delivery and the remaining four by caesarean sections performed entirely on the basis of obstetric indications instead of complications such as liver herniation. Liver herniation was present in 47% of vaginal deliveries with no complications, such as sac rupture and liver hemorrhage [16]. The policy in our institute is that all babies with omphalocele who have been delivered by spontaneous vaginal delivery with the exception of those who are shown to have liver herniation on antenatal ultrasound examinations.…”