Investigation of a connection between abdominal wall defects and severity of the herniation in fetuses with gastroschisis and omphalocele

Abstract

Analyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3–5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9–5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6–3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2–3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r2 = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.

Abdominal Wall Defects in Prenatal Medicine

“…It's widely established that the study of the embryogenetic process [15,25,26,27] of the abdominal wall, allows to understand the events of failure in one of it's phases. Biometric parameters have been recently studied [17], during autopsies of fetuses affected by G and O, to look for a probable correlation between the number of herniated organs and the size of the defect.…”

“…It's widely established that the study of the embryo genetic process [15,25,26,27] of the abdominal wall, allows to understand the events of failure in one of its phases. Biometric parameters have been recently studied [17], during autopsies of fetuses affected by G and O, to look for a probable correlation between the number of herniated organs and the size of the defect. We that's have performed an updated historical review, which will be exposed in a separate section, of the various stages of the normal and malformated fetuses and the prenatal therapy which could be published with a view to using the current state of the art, to acquire further insights.…”

Meeting in the middle: pediatric abdominal wall reconstruction for omphalocele

“…Many small defects (≤ 4 cm) are able to be repaired primarily in the rst several days of life [2] whereas peripartum ruptured omphaloceles carry high morbidity and mortality and require emergent intervention with resuscitation and stabilization of the neonate [4]. Giant omphaloceles (≥ 5cm) often necessitate considerable reconstruction given the loss of abdominal domain and potential for rectus abdominis malpositioning and underdevelopment [5]. Timing of giant omphalocele repair is variable and surgeondependent with repair occurring immediately in the neonatal period or in a delayed fashion in the rst few years of life [6].…”