Abstract
A review of six years' experience with antenatal diagnosis of abdominal wall defects by ultrasound showed its impact to be limited by poor detection rates. Twenty infants with exomphalos and 20 with gastroschisis were recorded but only 25 (63%) were diagnosed antenatally. The ultrasound false negative rate was higher for exomphalos (35%) than for gastroschisis (22%). No difference was detected in the incidence of associated abnormalities, premature gestation, primary closure rate, or mortality between the antenatally and postnatally diagnosed groups for either exomphalos or gastroschisis. Antenatal diagnosis of gastroschisis has little effect on management but allows parental counselling and in utero transfer. The frequency of concomitant abnormalities in exomphalos profoundly affects prognosis and the detection of these is the major role of antenatal diagnosis in this condition. Failure to detect abdominal wall defects by ultrasound may be a reflection of technique or equipment, but some gastroschisis may be of perinatal onset and not detectable antenatally.
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- Bond S. J., Harrison M. R., Filly R. A., Callen P. W., Anderson R. A., Golbus M. S. Severity of intestinal damage in gastroschisis: correlation with prenatal sonographic findings. J Pediatr Surg. 1988 Jun;23(6):520–525. doi: 10.1016/s0022-3468(88)80360-9. [DOI] [PubMed] [Google Scholar]
- Davidson J. M., Johnson T. R., Jr, Rigdon D. T., Thompson B. H. Gastroschisis and omphalocele: prenatal diagnosis and perinatal management. Prenat Diagn. 1984 Sep-Oct;4(5):355–363. doi: 10.1002/pd.1970040506. [DOI] [PubMed] [Google Scholar]
- Hershenson M. B., Brouillette R. T., Klemka L., Raffensperger J. D., Poznanski A. K., Hunt C. E. Respiratory insufficiency in newborns with abdominal wall defects. J Pediatr Surg. 1985 Aug;20(4):348–353. doi: 10.1016/s0022-3468(85)80217-7. [DOI] [PubMed] [Google Scholar]
- 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 Jul 1;146(5):512–518. doi: 10.1016/0002-9378(83)90791-3. [DOI] [PubMed] [Google Scholar]
- Knott P. D., Colley N. V. Can fetal gastroschisis always be diagnosed prenatally? Prenat Diagn. 1987 Oct;7(8):607–610. doi: 10.1002/pd.1970070812. [DOI] [PubMed] [Google Scholar]
- Lenke R. R., Hatch E. I., Jr Fetal gastroschisis: a preliminary report advocating the use of cesarean section. Obstet Gynecol. 1986 Mar;67(3):395–398. [PubMed] [Google Scholar]
- MOORE T. C. GASTROSCHISIS WITH ANTENATAL EVISCERATION OF INTESTINES AND URINARY BLADDER. Ann Surg. 1963 Aug;158:263–269. doi: 10.1097/00000658-196308000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mann L., Ferguson-Smith M. A., Desai M., Gibson A. A., Raine P. A. Prenatal assessment of anterior abdominal wall defects and their prognosis. Prenat Diagn. 1984 Nov-Dec;4(6):427–435. doi: 10.1002/pd.1970040606. [DOI] [PubMed] [Google Scholar]
- Nakayama D. K., Harrison M. R., Gross B. H., Callen P. W., Filly R. A., Golbus M. S., Stephens J. D., de Lorimier A. A. Management of the fetus with an abdominal wall defect. J Pediatr Surg. 1984 Aug;19(4):408–413. doi: 10.1016/s0022-3468(84)80264-x. [DOI] [PubMed] [Google Scholar]
- Nielsen L. B., Bang J., Nørgaard-Pedersen B. Prenatal diagnosis of omphalocele and gastroschisis by ultrasonography. Prenat Diagn. 1985 Nov-Dec;5(6):381–392. doi: 10.1002/pd.1970050604. [DOI] [PubMed] [Google Scholar]
- Redford D. H., McNay M. B., Whittle M. J. Gastroschisis and exomphalos: precise diagnosis by midpregnancy ultrasound. Br J Obstet Gynaecol. 1985 Jan;92(1):54–59. doi: 10.1111/j.1471-0528.1985.tb01048.x. [DOI] [PubMed] [Google Scholar]
- 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 Feb;156(2):308–312. doi: 10.1016/0002-9378(87)90274-2. [DOI] [PubMed] [Google Scholar]