Am J Perinatol 2011; 28(8): 627-634
DOI: 10.1055/s-0031-1276737
© Thieme Medical Publishers

Perinatal Outcome in the Live-Born Infant with Prenatally Diagnosed Omphalocele

Michelle A. Kominiarek1 , Noelia Zork2 , Sara Michelle Pierce3 , Terrell Zollinger4
  • 1Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
  • 2Harbor UCLA Medical Center, Torrance, California
  • 3Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
  • 4Department of Public Health, Indiana University School of Medicine, Indianapolis, Indiana
Further Information

Publication History

Publication Date:
03 May 2011 (online)

ABSTRACT

We compared perinatal outcomes between live-born nonisolated and isolated omphaloceles diagnosed during a prenatal ultrasound. Fetuses (n = 86) with omphalocele were identified between 1995 and 2007 at a single institution. Inclusion criteria were an omphalocele >14 weeks' gestation, available fetal and/or neonatal karyotype, and a live-born infant (n = 46). Perinatal outcomes were compared in nonisolated (n = 23) and isolated omphaloceles (n = 23). For all omphaloceles, the majority delivered after 34 weeks by cesarean. Mean birth weight (2782 versus 2704 g), median length of stay (27 versus 25 days), and mortality (two deaths in each group) were not different between the nonisolated and isolated groups (p > 0.05). In the nonisolated group, seven major anomalies were not confirmed postnatally. Of the prenatally diagnosed isolated omphaloceles, 8 (35%) were diagnosed with a syndrome or other anomalies after birth. The outcomes were similar in nonisolated and isolated prenatally diagnosed omphaloceles, but ultrasound did not always accurately determine the presence or absence of associated anomalies.

REFERENCES

  • 1 Mann S, Blinman T A, Douglas Wilson R. Prenatal and postnatal management of omphalocele.  Prenat Diagn. 2008;  28 626-632
  • 2 Nyberg D A, Fitzsimmons J, Mack L A et al.. Chromosomal abnormalities in fetuses with omphalocele. Significance of omphalocele contents.  J Ultrasound Med. 1989;  8 299-308
  • 3 Benacerraf B R, Saltzman D H, Estroff J A, Frigoletto Jr F D. Abnormal karyotype of fetuses with omphalocele: prediction based on omphalocele contents.  Obstet Gynecol. 1990;  75 (3 Pt 1) 317-319
  • 4 Hughes M D, Nyberg D A, Mack L A, Pretorius D H. Fetal omphalocele: prenatal US detection of concurrent anomalies and other predictors of outcome.  Radiology. 1989;  173 371-376
  • 5 St-Vil D, Shaw K S, Lallier M et al.. Chromosomal anomalies in newborns with omphalocele.  J Pediatr Surg. 1996;  31 831-834
  • 6 Heider A L, Strauss R A, Kuller J A. Omphalocele: clinical outcomes in cases with normal karyotypes.  Am J Obstet Gynecol. 2004;  190 135-141
  • 7 Nicholas S S, Stamilio D M, Dicke J M, Gray D L, Macones G A, Odibo A O. Predicting adverse neonatal outcomes in fetuses with abdominal wall defects using prenatal risk factors.  Am J Obstet Gynecol. 2009;  201 383 e1-e6
  • 8 Brantberg A, Blaas H G, Haugen S E, Eik-Nes S H. Characteristics and outcome of 90 cases of fetal omphalocele.  Ultrasound Obstet Gynecol. 2005;  26 527-537
  • 9 Hidaka N, Tsukimori K, Hojo S et al.. Correlation between the presence of liver herniation and perinatal outcome in prenatally diagnosed fetal omphalocele.  J Perinat Med. 2009;  37 66-71
  • 10 Boyd P A, Bhattacharjee A, Gould S, Manning N, Chamberlain P. Outcome of prenatally diagnosed anterior abdominal wall defects.  Arch Dis Child Fetal Neonatal Ed. 1998;  78 F209-F213
  • 11 Mabogunje O A, Mahour G H. Omphalocele and gastroschisis. Trends in survival across two decades.  Am J Surg. 1984;  148 679-686
  • 12 Mayer T, Black R, Matlak M E, Johnson D G. Gastroschisis and omphalocele. An eight-year review.  Ann Surg. 1980;  192 783-787
  • 13 Kirk E P, Wah R M. Obstetric management of the fetus with omphalocele or gastroschisis: a review and report of one hundred twelve cases.  Am J Obstet Gynecol. 1983;  146 512-518
  • 14 Stoll C, Alembik Y, Dott B, Roth M P. Risk factors in congenital abdominal wall defects (omphalocele and gastroschisi): a study in a series of 265,858 consecutive births.  Ann Genet. 2001;  44 201-208
  • 15 Fratelli N, Papageorghiou A T, Bhide A, Sharma A, Okoye B, Thilaganathan B. Outcome of antenatally diagnosed abdominal wall defects.  Ultrasound Obstet Gynecol. 2007;  30 266-270
  • 16 Garne E, Loane M, Dolk H. EUROCAT Working Group . Gastrointestinal malformations: impact of prenatal diagnosis on gestational age at birth.  Paediatr Perinat Epidemiol. 2007;  21 370-375
  • 17 Calvert N, Damiani S, Sunario J, Bower C, Dickinson J E. The outcomes of pregnancies following a prenatal diagnosis of fetal exomphalos in Western Australia.  Aust N Z J Obstet Gynaecol. 2009;  49 371-375
  • 18 Kamata S, Ishikawa S, Usui N et al.. Prenatal diagnosis of abdominal wall defects and their prognosis.  J Pediatr Surg. 1996;  31 267-271
  • 19 Centers for Disease Control and Prevention (CDC) . Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects—United States, 2003.  MMWR Morb Mortal Wkly Rep. 2007;  56 25-29
  • 20 Wladimiroff J W, Molenaar J C, Niermeijer M F, Stewart P A, van Eyck J. Prenatal diagnosis and management of omphalocele.  Eur J Obstet Gynecol Reprod Biol. 1983;  16 19-23
  • 21 Schwaitzberg S D, Pokorny W J, McGill C W, Harberg F J. Gastroschisis and omphalocele.  Am J Surg. 1982;  144 650-654
  • 22 Wilkins-Haug L, Porter A, Hawley P, Benson C B. Isolated fetal omphalocele, Beckwith-Wiedemann syndrome, and assisted reproductive technologies.  Birth Defects Res A Clin Mol Teratol. 2009;  85 58-62
  • 23 Williams D H, Gauthier D W, Maizels M. Prenatal diagnosis of Beckwith-Wiedemann syndrome.  Prenat Diagn. 2005;  25 879-884
  • 24 Elliott M, Maher E R. Beckwith-Wiedemann syndrome.  J Med Genet. 1994;  31 560-564
  • 25 Kirk E P, Wah R M. Obstetric management of the fetus with omphalocele or gastroschisis: a review and report of one hundred twelve cases.  Am J Obstet Gynecol. 1983;  146 512-518
  • 26 Lewis D F, Towers C V, Garite T J, Jackson D N, Nageotte M P, Major C A. Fetal gastroschisis and omphalocele: is cesarean section the best mode of delivery?.  Am J Obstet Gynecol. 1990;  163 773-775
  • 27 Lurie S, Sherman D, Bukovsky I. Omphalocele delivery enigma: the best mode of delivery still remains dubious.  Eur J Obstet Gynecol Reprod Biol. 1999;  82 19-22
  • 28 Moretti M, Khoury A, Rodriquez J, Lobe T, Shaver D, Sibai B. The effect of mode of delivery on the perinatal outcome in fetuses with abdominal wall defects.  Am J Obstet Gynecol. 1990;  163 833-838
  • 29 Sermer M, Benzie R J, Pitson L, Carr M, Skidmore M. Prenatal diagnosis and management of congenital defects of the anterior abdominal wall.  Am J Obstet Gynecol. 1987;  156 308-312
  • 30 Sipes S L, Weiner C P, Sipes II D R, Grant S S, Williamson R A. Gastroschisis and omphalocele: does either antenatal diagnosis or route of delivery make a difference in perinatal outcome?.  Obstet Gynecol. 1990;  76 195-199
  • 31 Lakasing L, Cicero S, Davenport M, Patel S, Nicolaides K H. Current outcome of antenatally diagnosed exomphalos: an 11 year review.  J Pediatr Surg. 2006;  41 1403-1406

Michelle A KominiarekM.D. 

840 South Wood Street, M/C 808, University of Illinois Medical Center at Chicago

Chicago, IL 60612

Email: Mkomin1@uic.edu

    >