Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome

Diemon, N.; Funke, Katrin; Möllers, Mareike; Hammer, K; Steinhard, J.; Sauerland, Cristina; Müller, V; Klockenbusch, Walter; Schmitz, Ralf

doi:10.1007/s00404-016-4236-1

Cited by 4 publications

(6 citation statements)

References 20 publications

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“…The latter study used fetal growth parameters (AC, femur length, and head circumference), which remained relatively constant throughout gestation. The suggested ratios resulted in a lower predictive value for the prediction of postnatal closure (AUC 0.67–0.72) than the OC/AC ratio in our study (AUC 0.96–0.98), as did all ratios including omphalocele diameter instead of circumference . Additional research should make clear whether correction for GA could result in a constant cut‐off throughout gestation, without negatively affecting the predictive value.…”

Section: Discussioncontrasting

confidence: 52%

“…In previous studies, a number of ratios have been investigated, 15,16,[18][19][20] including the OC/AC ratio. 17,20 Differing outcome parameters and study population inclusion criteria hamper comparison.…”

Section: Discussionmentioning

confidence: 99%

“…The cut-offs we found in the current study are lower than previously reported 17 the OC/AC ratio in our study (AUC 0.96-0.98), as did all ratios including omphalocele diameter instead of circumference. 16,18,19 Additional research should make clear whether correction for GA could result in a constant cut-off throughout gestation, without negatively affecting the predictive value.…”

Section: Discussionmentioning

confidence: 99%

“…Today, around 90% of omphaloceles and most of the additional anomalies are detected by prenatal ultrasound from 11 week gestation onwards . Previous studies have shown that ultrasound parameters can predict postnatal outcome in fetuses with an omphalocele . More recent studies showed that the ratio between the omphalocele circumference (OC) and the abdominal circumference (AC)—the OC/AC ratio—predicts the method of postnatal surgical closure .…”

Section: Introductionmentioning

confidence: 99%

“…2,14 Previous studies have shown that ultrasound parameters can predict postnatal outcome in fetuses with an omphalocele. [15][16][17][18][19] More recent studies showed that the ratio between the omphalocele circumference (OC) and the abdominal circumference (AC)-the OC/AC ratio-predicts the method of postnatal surgical closure. 17,20 These studies were mostly limited to single measurements and infants whose omphalocele was assumed to be isolated at prenatal ultrasound.…”

Section: Introductionmentioning

confidence: 99%

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The validity of the viscero‐abdominal disproportion ratio for type of surgical closure in all fetuses with an omphalocele

et al. 2019

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ObjectiveTo determine the predictive value of the fetal omphalocele circumference/abdominal circumference (OC/AC) ratio for type of surgical closure and survival and to describe the trajectory of OC/AC ratio throughout gestation.MethodsThis cohort study included all live‐born infants prenatally diagnosed with an omphalocele in our tertiary centre (2000–2017) with an intention to treat. The OC/AC ratio and liver position were determined using 2D ultrasound at three periods during gestation (11–16, 17–26, and/or 30–38 weeks). Primary outcome was type of closure; secondary outcome was survival. In the secondary analyses, the predictive value of the OC/AC‐ratio trend for type of closure and survival was assessed.ResultsPrimary closure was performed in 37/63 (59%) infants, and 54/63 (86%) survived. The OC/AC ratio was predictive for type of closure and survival in all periods. Optimal cut‐off values for predicting closure decreased throughout gestation from 0.69 (11–16 weeks) to 0.63 (30–38 weeks). Repeated OC/AC‐ratio measurements were available in 33 (73%) fetuses. The trend of the OC/AC ratio throughout gestation was not significantly associated with type of closure. All infants without liver herniation underwent primary closure.ConclusionType of omphalocele surgical closure and survival can be predicted prenatally on the basis of the OC/AC ratio and liver herniation independent of associated anomalies.Learning objectiveThe reader will be able to use the OC/AC ratio throughout gestation in all omphalocele cases for prediction of type of closure and survival and thus patient counselling.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The validity of the viscero‐abdominal disproportion ratio for type of surgical closure in all fetuses with an omphalocele

et al. 2019

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Anatomic parameters of omphaloceles and their association with anatomic, genetic, or syndromic malformations: a retrospective study

Parata,

Vial,

Addor

et al. 2024

Pediatr Surg Int

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Purpose This retrospective study aims to describe anatomical parameters of omphaloceles and to analyze their association with anatomical, genetic, or syndromic malformations. Methods Cases were selected from digital records of two university centers, a certified regional registry and personal records. Patients from 1998 to 2018 with omphalocele and live birth (LB), termination of pregnancy due to fetal anomaly (TOPFA) and fetal death (FD) were included. Cases born outside Western Switzerland and/or with upper or lower coelosomy were excluded. Results We analyzed 162 cases with the following distribution: 57 (35%) LB, 91 (56%) TOPFA and 14 (9%) FD. TOPFA was significantly more frequently performed in cases with non-isolated omphalocele, i.e., omphaloceles with associated major malformations (especially cardiovascular and genitourinary), genetic/chromosomal anomalies, or syndromes. For LB, associated anatomical malformations, genetic or chromosomal anomalies were not significantly associated with the size of the omphalocele or the liver involvement. Conclusions The proportion of cases resulting in TOPFA was higher among fetuses with major malformations, genetic or chromosomal anomalies. Despite the large size of this cohort, and in contrary to previous publications, the size of the omphalocele and/or liver involvement does not allow for conclusions regarding the presence or number of associated malformations, genetic or chromosomal anomalies.

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Ruptured omphalocele: Diagnosis and management

Gonzalez

Chandler

2019

Seminars in Pediatric Surgery

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Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome

Abstract: Thorax diameter or defect diameter of giant omphaloceles is not predictive for fetal outcome. The perinatal care of these abdominal wall defects still remains a multidisciplinary challenge, but the outcome of giant omphaloceles is favorable at experienced centers.

Cited by 4 publications

References 20 publications

The validity of the viscero‐abdominal disproportion ratio for type of surgical closure in all fetuses with an omphalocele

The validity of the viscero‐abdominal disproportion ratio for type of surgical closure in all fetuses with an omphalocele

Anatomic parameters of omphaloceles and their association with anatomic, genetic, or syndromic malformations: a retrospective study

Ruptured omphalocele: Diagnosis and management

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