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Prenatal ultrasonic diagnosis of anterior abdominal wall defects
Insights
Prenatal ultrasound effectively diagnosed various anterior abdominal wall defects, including gastroschisis, omphalocele, cloacal exstrophy, and prune belly syndrome. This study details their distinct ultrasonic features for accurate diagnosis.
Area of Science:
- Medical Imaging
- Prenatal Diagnosis
- Fetal Medicine
Background:
- Anterior abdominal wall defects (AAWDS) are congenital anomalies requiring accurate prenatal diagnosis.
- Ultrasound is a primary tool for fetal anomaly screening and diagnosis.
- Specific AAWDS like gastroschisis and omphalocele have established sonographic appearances.
Purpose of the Study:
- To report and discuss the prenatal ultrasonic diagnosis of nine cases of AAWDS.
- To highlight the sonographic features of less common or previously unreported AAWDS.
- To provide guidelines for differentiating various AAWDS prenatally.
Main Methods:
- Retrospective analysis of nine prenatal ultrasound cases diagnosed with AAWDS.
- Detailed review of sonographic findings for each defect type: gastroschisis, omphalocele, cloacal exstrophy, and prune belly syndrome.
- Comparison of ultrasonic features to aid differential diagnosis.
Main Results:
- Successfully diagnosed gastroschisis (1), omphalocele (5), cloacal exstrophy (1), and prune belly syndrome (2) via prenatal ultrasound.
- Cloacal exstrophy, a rare entity, presented with a large infraumbilical defect, fetal ascites, and lumbosacral myelomeningocele.
- Prune belly syndrome showed absent abdominal musculature and cystic dilatation of the urinary tract.
Conclusions:
- Prenatal ultrasound is crucial for diagnosing a spectrum of AAWDS.
- Recognizing specific ultrasonic markers aids in differentiating gastroschisis, omphalocele, cloacal exstrophy, and prune belly syndrome.
- Accurate prenatal diagnosis facilitates appropriate management and counseling.
Abstract:
Nine cases of different types of anterior abdominal wall defects were diagnosed prenatally by ultrasound: gastroschisis (one case), omphalocele (five cases), exstrophy of the cloaca (one case) and the extreme form of prune belly syndrome (two cases). The ultrasonic features of gastroschisis and omphalocele are well recognized by most experienced sonographists. The ultrasonic prenatal diagnosis of exstrophy of the cloaca has not been reported previously and it is a very rare entity. The anterior abdominal wall defect is larger than in omphalocene and is located infraumbilically. Fetal ascites and a lumbosacral myelomeningocele are present as well. The extreme form of prune belly syndrome is associated with the absence of the abdominal wall musculature and marked dilatation of the urinary tract, presented ultrasonically as multiple large cysts occupying the distended fetal abdominal cavity. The differential diagnosis of these entities and guidelines for their correct prenatal ultrasonic diagnosis will be discussed.