Outcome of Antenatally Diagnosed Fetal Anterior Abdominal Wall Defects from a Single Tertiary Centre

Objective: The aim of this study was to review the outcome of all cases of antenatally diagnosed anterior abdominal wall defects at a single tertiary centre. Method: 41 cases from the database of the Centre of Fetal Care at Queen Charlotte’s and Chelsea Hospital in London from 2000 to 2005 were reviewed and both obstetric and neonatal data were collected. Results: 25 cases were exomphalos (61%), 9 were gastroschisis (22%), 6 were body stalk anomaly (15%) and 1 case was cloacal exstrophy (2%). 17 cases (41%) were associated with other major malformations and 4 (10%) were aneuploid. There was 1 case of intrauterine death (2%). Termination of pregnancy was performed in 24 cases (63%). Of the cases that continued (exomphalos and gastroschisis), all babies survived surgery and were discharged home. Conclusions: This study demonstrates a high termination rate for fetuses diagnosed with anterior abdominal wall defects. However, the surgical outcome for euploid neonates with isolated exomphalos or gastroschisis appears to be good. Babies with gastroschisis required a longer period of parenteral feeding compared with babies with exomphalos. These infants however had a longer duration of hospitalization.

[1]  A. Flake,et al.  Gastroschisis: Growth Patterns and a Proposed Prenatal Surveillance Protocol , 2007, Fetal Diagnosis and Therapy.

[2]  L. Sbragia,et al.  Aminiotic Fluid and Intrauterine Growth Restriction in a Gastroschisis Fetal Rat Model , 2005, Fetal Diagnosis and Therapy.

[3]  R. D. Wilson,et al.  Congenital Abdominal Wall Defects: An Update , 2004, Fetal Diagnosis and Therapy.

[4]  J. Langer Abdominal Wall Defects , 2003, World Journal of Surgery.

[5]  V. Berghella,et al.  Abdominal wall defects and congenital heart disease , 2003, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[6]  H. Halsband,et al.  [Omphalocele and gastroschisis. Outcome--complications--follow-up--quality of life]. , 2000, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[7]  R. D. Merz,et al.  Epidemiology of abdominal wall defects, Hawaii, 1986-1997. , 1999, Teratology.

[8]  M. Kilby,et al.  Congenital anterior abdominal wall defects in England and Wales 1987–93: retrospective analysis of OPCS data , 1996, BMJ.

[9]  S. Yazbeck,et al.  Chromosomal anomalies in newborns with omphalocele. , 1996, Journal of pediatric surgery.

[10]  F. Bianchi,et al.  Omphalocele and gastroschisis in Europe: a survey of 3 million births 1980-1990. EUROCAT Working Group. , 1995, American journal of medical genetics.

[11]  D. Tibboel,et al.  A comparative investigation of the bowel wall in gastroschisis and omphalocele: relation to postoperative complications. , 1987, Pediatric pathology.