Related Experiment Videos
Impact of antenatal diagnosis on incidence and prognosis in abdominal wall defects
R Fisher1, A Attah, A Partington
1South East Thames Congenital Malformation Registry, Children's Hospital, London, England.
Insights
Gastroschisis and exomphalos are fetal abdominal wall defects. While gastroschisis has a high survival rate, exomphalos is linked to severe anomalies, impacting prognosis.
Area of Science:
- Perinatal Medicine
- Pediatric Surgery
- Medical Genetics
Background:
- Fetal abdominal wall defects, including gastroschisis and exomphalos, are significant congenital anomalies.
- Accurate diagnosis and prognostic assessment are crucial for effective management and parental counseling.
Purpose of the Study:
- To analyze the incidence and outcomes of fetal abdominal wall defects.
- To compare the prognoses of gastroschisis and exomphalos.
- To identify factors influencing survival rates in affected neonates.
Main Methods:
- Retrospective review of cases from the Congenital Malformation Registry in South East Thames.
- Data collection over a 24-month period.
- Analysis of associated anomalies, chromosomal defects, and survival rates.
Main Results:
- Eighty cases were observed: 40 gastroschisis and 40 exomphalos.
- Live-born infants with gastroschisis showed few associated anomalies and an 83% survival rate.
- Exomphalos cases had a higher rate of life-threatening anomalies and chromosomal defects, with many terminated prenatally.
- Excluding cases with severe chromosomal anomalies, the 1-year survival rate for liveborn exomphalos infants was approximately 80%.
Conclusions:
- Gastroschisis generally carries a favorable prognosis in live-born infants without significant associated anomalies.
- Exomphalos prognosis is highly dependent on the presence of associated life-threatening anomalies and chromosomal defects.
- Prenatal ultrasonography identification of these defects, coupled with genetic assessment, aids in determining fetal prognosis.
Abstract:
The authors review data from the Congenital Malformation Registry in South East Thames regarding fetal abdominal wall defects. Over 24 months, 80 cases were observed (40 gastroschisis, 40 exomphalos). Live-born infants with gastroschisis had few associated anomalies and an excellent prognosis (83% survival rate). Exomphalos is associated with an increased rate of life-threatening anomalies and chromosomal defects. The latter cases often are terminated prenatally. If these cases are excluded, the 1-year survival rate for liveborn infants with exomphalos is favorable (close to 80%). Fetuses in whom gastroschisis and exomphalos are identified by ultrasonography but who have no associated life-threatening chromosomal anomalies should have a favorable prognosis.