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%.
Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, UK.
N
N
Fratelli
A T
AT
Papageorghiou
A
A
Bhide
A
A
Sharma
B
B
Okoye
B
B
Thilaganathan
D034861:Abdominal Wall / Q000000981:diagnostic imaging; D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging; D002869:Chromosome Aberrations; D005260:Female; D005313:Fetal Death; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000235:genetics / Q000601:surgery; D005865:Gestational Age; D006554:Hernia, Umbilical / Q000000981:diagnostic imaging* / Q000235:genetics / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods