Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome.
OBJECTIVE
To investigate the relationship between the thorax diameter and defect diameter of giant omphaloceles as a predictor for fetal outcome.


METHODS
In a retrospective study, 17 fetuses with isolated giant omphaloceles were included for evaluation. The anterior-posterior thorax diameter and the defect diameter were measured from ultrasound images. For analysis, the thorax-to-head ratio (T/HC), the defect diameter-to-head ratio (DD/HC), and the quotient of the defect diameter and the thorax diameter (DD/T) were calculated. The days of ventilation (tventilation), the duration until hospital discharge (thospital), and the type of treatment were recorded as outcome parameters.


RESULTS
No relationship was found between the calculated ratios (T/HC, DD/HC, or DD/T) and neither thospital(r = -0.418, p = 0.095; r = -0.153, p = 0.556; and r = -0.023, p = 0.929; respectively) nor tventilation(r = -0.391, p = 0.121; r = 0.041, p = 0.875; and r = 0.121, p = 0.645, respectively). The type of postnatal treatment was not associated with the three calculated ratios or thospital(r = 0.155, p = 0.553; r = 0.019, p = 0.942; and r = 0.012, p = 0.965; r = -0.009, p = 0.973, respectively). In 53% of cases, thospitalwas delayed due to additional and independent postnatal complications.


CONCLUSIONS
Thorax diameter or defect diameter of giant omphaloceles is not predictive for fetal outcome. The perinatal care of these abdominal wall defects still remains a multidisciplinary challenge, but the outcome of giant omphaloceles is favorable at experienced centers.
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. diemon.nina@gmail.com.
Nina
N
Diemon
Department of Pediatric Surgery, University Hospital of Münster, Münster, Germany.
Katrin
K
Funke
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Mareike
M
Möllers
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Kerstin
K
Hammer
Department of Fetal Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany.
Johannes
J
Steinhard
Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany.
Cristina
C
Sauerland
Department of Pediatric Surgery, University Hospital of Münster, Münster, Germany.
Volker
V
Müller
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Walter
W
Klockenbusch
Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Ralf
R
Schmitz
D000328:Adult; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006257:Head / Q000473:pathology*; D006554:Hernia, Umbilical / Q000401:mortality / Q000473:pathology*; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D013909:Thorax / Q000473:pathology*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult
Fetal outcome; Giant omphaloceles; Perinatal outcome; Pulmonary hypoplasia; Thorax diameter