Usefulness of Postnatal Echocardiograms in Patients with Omphaloceles Who Previously Had a Normal Fetal Echocardiogram

Clark, Michael G.; Aldrink, Jennifer H.; Richards, Bernadette; Corbitt, Rebecca; Stiver, Corey; Clifford, L.

doi:10.1007/s40119-021-00243-5

Cited by 1 publication

(3 citation statements)

References 24 publications

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“…It is important to note that even in the setting of a normal karyotype, at least 50% of fetuses with omphalocele may have other abnormalities, and the cardiac ones are the most frequent. This is why the American Heart Association recommends performing a fetal echocardiogram in all fetuses when extra cardiac abnormalities are present [ 22 ]. Septal defects are the most frequent cardiac abnormalities associated with omphalocele, followed by tetralogy of Fallot, ectopia cordis, tricuspid atresia, hypoplastic left heart syndrome, and others [ 6 ].…”

Section: Omphalocele Patients With Cardiac Abnormalitiesmentioning

confidence: 99%

“…The sensitivity for fetal echocardiograms to detect complex congenital heart defects is greater than 80% [ 71 ]. Anyway, if a complex cardiac malformation is found on fetal ultrasound, and especially if the ventricular septum is involved, fetal MRI may be recommended for a better evaluation and for family counseling [ 6 , 22 , 72 ]. In the presence of the association of several congenital anomalies, the mother will be directed to a tertiary center specialized in maternal–fetal medicine, both for counseling, follow-up, pre-, and postnatal treatment.…”

Section: Managementmentioning

confidence: 99%

“…Pulmonary hypertension is usually associated with other congenital anomalies, longer durations of mechanical ventilation, and the need for high-frequency oscillatory ventilation and/or tracheostomy [ 74 ]. However, a recent study demonstrated that critical congenital heart defects were not missed on any patient with an omphalocele who had a normal fetal echocardiogram, so a routine postnatal transthoracic echocardiogram may not be needed in those neonates with a normal clinical workup [ 22 ]. If a murmur is heard during auscultation, if an abnormal EKG or abnormal chest X-ray are detected on postnatal evaluation, or desaturation based on pulse oximetry is noted, and if signs and symptoms of congestive heart failure appear, then further testing and echocardiography should be performed to guide patient management [ 75 ].…”

Section: Managementmentioning

confidence: 99%

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Omphalocele and Cardiac Abnormalities—The Importance of the Association

Ţarcă

Namat²,

Luca

et al. 2023

Diagnostics

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Omphalocele is the most common ventral abdominal wall defect. Omphalocele is associated with other significant anomalies in up to 80% of cases, among which the cardiac ones are the most frequent. The aim of our paper is to highlight, through a review of the literature, the importance and frequency of association between the two malformations and what impact this association has on the management and evolution of patients with these pathologies. We reviewed the titles, the available abstracts, and the full texts of 244 papers from the last 23 years, from three medical databases, to extract data for our review. Due to the frequent association of the two malformations and the unfavorable effect of the major cardiac anomaly on the prognosis of the newborn, the electrocardiogram and echocardiography must be included in the first postnatal investigations. The timing of surgery for abdominal wall defect closure is mostly dictated by the cardiac defect severity, and usually the cardiac defect takes priority. After the cardiac defect is medically stabilized or surgically repaired, the omphalocele reduction and closure of the abdominal defect are performed in a more controlled setting, with improved outcomes. Compared to omphalocele patients without cardiac defects, children with this association are more likely to experience prolonged hospitalizations, neurologic, and cognitive impairments. Major cardiac abnormalities such as structural defects that require surgical treatment or result in developmental delay will significantly increase the death rate of patients with omphalocele. In conclusion, the prenatal diagnosis of omphalocele and early detection of other associated structural or chromosomal anomalies are of overwhelming importance, contributing to the establishment of antenatal and postnatal prognosis.

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Section: Omphalocele Patients With Cardiac Abnormalitiesmentioning

confidence: 99%