Fetal abdominal wall defects in an Australian tertiary setting: contemporary characteristics, ultrasound accuracy, and outcome

Filippo, Daria Di; Henry, Amanda; Patel, J.U.; Jiwane, Ashish; Welsh, A.W.

doi:10.1080/14767058.2019.1633303

Cited by 4 publications

(3 citation statements)

References 32 publications

(37 reference statements)

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“…For omphalocele, the number of associated malformations ranges from 27% to 63%, and for gastroschisis, it ranges from 5% to 27%. 16,17 In a different study, 98 cases diagnosed with omphalocele in the first trimester were evaluated. 18 It was observed that 45.9% of the cases had major structural anomalies, and 53.8% had chromosomal anomalies.…”

Section: Discussionmentioning

confidence: 99%

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Omphalocele and gastroschisis: An analysis of prenatal diagnosis and neonatal outcomes

Doğru,

Akkuş,

Ezveci

et al. 2023

Sonography

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BackgroundOmphalocele and gastroschisis are the most frequent congenital developmental abdominal wall defects. Prenatal diagnosis of omphalocele and gastroschisis is critical in the management of the pregnancy, affording patients the option of termination. This study aims to evaluate the prenatal diagnosis and postnatal outcomes of omphalocele and gastroschisis cases.Materials and MethodsThe cases of gastroschisis and omphalocele diagnosed prenatally and followed up at our university were evaluated retrospectively between January 2019 and January 2022. Maternal demographic and clinical characteristics and perinatal outcomes were compared between the cases.ResultsThis study evaluated 42 omphalocele and nine gastroschisis cases. All gastroschisis cases were isolated (p = .001). Additional anomalies were present in 61.9% of omphalocele cases. While two patients with gastroschisis refused the invasive procedure, the genetic results of the others were normal. The karyotype was abnormal in 42.9% of omphalocele cases (p = .008). Half of the omphalocele cases were terminated, and 38.1% (n = 8) of the terminated omphalocele cases were trisomy 18. The coexistence of multiple system anomalies and cystic hygroma was high in the terminated cases. In all cases of gastroschisis, only the intestines protruded from the abdominal wall into the amniotic fluid. The number of survivors of omphalocele was 23.8%. The median hospital stay was 25 and 14 days for gastroschisis and omphalocele, respectively.ConclusionPrenatal diagnosis of omphalocele and gastroschisis is critical in pregnancy management. The presence of associated anomalies determines the prognosis of omphalocele and gastroschisis.

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Section: Discussionmentioning

confidence: 99%

“…The presence of associated anomalies determines the prognosis of omphalocele and gastroschisis. For omphalocele, the number of associated malformations ranges from 27% to 63%, and for gastroschisis, it ranges from 5% to 27% 16,17 . In a different study, 98 cases diagnosed with omphalocele in the first trimester were evaluated 18 .…”

Section: Discussionmentioning

confidence: 99%

Omphalocele and gastroschisis: An analysis of prenatal diagnosis and neonatal outcomes

Doğru,

Akkuş,

Ezveci

et al. 2023

Sonography

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“…Another recent study by Di Filippo et al 24 . compared sonographic EFW in fetuses with AWDs using both the Hadlock I and II formulae and the Siemer formula.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of sonographic estimation of weight in fetuses with abdominal wall defects

Spaulding

Edwards

Coombs

et al. 2020

Aust NZ J Obst Gynaeco

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Background: Accurate estimation of fetal weight is essential in guiding management of fetuses with abdominal wall defects (AWDs), as growth restriction is an important predictor of perinatal morbidity and mortality. Several sonographic formulae are available involving multiple biometric parameters, but abdominal circumference measurements may underestimate weight in fetuses with AWDs. No formula has yet shown superior accuracy. Aims: The objectives of this study were to evaluate, in fetuses with gastroschisis and omphalocoele, the accuracy of a sonographic estimated fetal weight (EFW) formula proposed by Siemer and colleagues, specifically for use in fetuses with AWDs compared to the commonly used Hadlock IV formula in estimating fetal weight, and detecting small for gestational age (SGA) fetuses. Materials and Methods: A retrospective cohort of 113 fetuses with AWDs was identified from an Australian teaching hospital over 13 years. Pregnancy data and sonographic fetal biometry parameters were obtained. The accuracy of each formula in predicting birthweight was compared using Bland-Altman limits of agreement, and the intraclass correlation coefficient between EFW and actual birthweight. Performance of each formula in detecting SGA fetuses was determined. Results: The Siemer and Hadlock formulae have similar accuracies for predicting birthweight in fetuses with AWDs. The Hadlock formula has a higher detection rate for SGA < 10 th centile and < 3 rd centile compared to the Seimer formula (84% vs 68% and 83% vs 67% respectively), albeit with a higher false-positive rate. Conclusion: There is no clear clinical advantage in using the Siemer formula, which is specifically designed for fetuses with AWDs, over the Hadlock formula to estimate weight in fetuses with AWDs.

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Estimating fetal weight in gastroschisis: A 10 year audit of outcomes at the National Maternity Hospital

O’Keeffe,

Mulligan,

McParland

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo identify whether conventional methods of estimating fetal growth (Hadlock's formula), which relies heavily on abdominal circumference measurements, are accurate in fetuses with gastroschisis.MethodsA retrospective cohort study was performed between the period January 1, 2011 and December 31, 2021 in a tertiary referral maternity hospital identifying all pregnancies with a diagnosis of gastroschisis. Projected fetal weight was obtained using the formula (EFW [Hadlock's formula] + 185 g × [X/7]) where X was the number of days to delivery.ResultsDuring the study period 41 cases were identified. The median maternal age was 25. The median BMI was 25 and 63% were primiparous women (n = 26). Median gestation at diagnosis was 21 weeks. Median gestation at delivery was 36 weeks. A total of 4.8% of mothers had a history of drug use (n = 2). The rate of maternal tobacco use was 21.9% (n = 9). A total of 4.8% of fetuses had additional congenital anomalies including amniotic band syndrome and myelomeningocele (n = 2).Estimated fetal weight (EFW) and birth weight data were available for 34 cases. A Wilcoxon signed‐rank test showed projected EFW using Hadlock's formula did not result in a statistically significant different birth weight (Z = −1.3, P = 0.169). Median projected weight and actual birth weight were 2241.35 and 2415 g respectively. Median difference was 0.64 g (95% CI: −148 to −28.5).ConclusionOur data showed accuracy using standard formulae for EFW in fetuses with gastroschisis.

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Fetal abdominal wall defects in an Australian tertiary setting: contemporary characteristics, ultrasound accuracy, and outcome

Cited by 4 publications

References 32 publications

Omphalocele and gastroschisis: An analysis of prenatal diagnosis and neonatal outcomes

Omphalocele and gastroschisis: An analysis of prenatal diagnosis and neonatal outcomes

Accuracy of sonographic estimation of weight in fetuses with abdominal wall defects

Estimating fetal weight in gastroschisis: A 10 year audit of outcomes at the National Maternity Hospital

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