[Echographic diagnosis and perinatal management in fetal abdominal wall defects]

Twenty-seven cases of foetal abdominal wall defects are described, diagnosed prenatally by means of real-time ultrasonography in the period 1 January 1980-31 December 1989, in the hospital of the Free University of Amsterdam. In 17 out of 20 (85%) cases with omphalocele there were additional abnormalities, mainly chromosomal defects (41%), cardiac (25%) and genitourinary (25%) malformations. In gastroschisis, associated structural anomalies occurred in 57% (4/7). No chromosomal defects were found in the group with gastroschisis. Intrauterine foetal death occurred in 10 cases. Seven pregnancies were electively aborted because of association with an anomaly incompatible with postnatal life. One child died at two months. Six children (4 with omphalocele, 2 with gastroschisis) were successfully treated surgically. When ultrasonography demonstrates a foetal abdominal wall defect detailed sonographic examination is recommended to exclude additional malformations. In case of omphalocele prenatal chromosome analysis is indicated. Delivery in a tertiary care center is recommended. Elective caesarean section does not appear justified.