Holland A J, Ford W D, Linke R J, Furness M E, Hayward C
Department of Paediatric Surgery, Division of Surgery, Division of Medical Imaging, Women's and Children's Hospital, Adelaide, S.A., Australia.
Fetal Diagn Ther. 1999 Jul-Aug;14(4):223-8. doi: 10.1159/000020926.
To determine the influence of antenatal ultrasound on the management of exomphalos.
Retrospective case note review of 23 fetuses and infants referred to our institution with either a pre- or postnatal diagnosis of exomphalos over a 7-year period.
There were 21 cases of exomphalos of which 18 were correctly diagnosed on antenatal ultrasound by 18 weeks' gestation. There were 2 false-positives and 3 false-negatives, including 1 case of amniotic band syndrome with an abdominal wall defect and 1 morphologically normal fetus. Associated anomalies were correctly identified in 12 but incorrectly reported in 8. Maternal serum alpha-fetoprotein levels were abnormal in 61% of cases of abdominal wall defects in this series. Amniocentesis was performed in 12 and cordocentesis in 1. There were 13 terminations, including 2 trisomy 18s and 1 trisomy 13. Two fetal deaths followed amniocentesis. Of the 10 live births, 9 had their exomphalos repaired with a 1-year survival rate of 89%. Prenatal diagnosis did not appear to influence outcome.
Antenatal ultrasound diagnosed 86% of cases of exomphalos and correctly reported 67% of associated anomalies. Amniocentesis may have led to the death of 1 morphologically normal fetus.
确定产前超声检查对外翻性脐膨出治疗的影响。
回顾性分析7年间转诊至我院的23例产前或产后诊断为外翻性脐膨出的胎儿及婴儿的病历。
21例为外翻性脐膨出，其中18例在孕18周时通过产前超声检查得到正确诊断。有2例假阳性和3例假阴性，包括1例合并腹壁缺损的羊膜带综合征和1例形态正常的胎儿。12例相关畸形得到正确识别，但8例报告有误。本系列中61%的腹壁缺损病例孕妇血清甲胎蛋白水平异常。12例行羊膜腔穿刺术，1例行脐静脉穿刺术。13例终止妊娠，其中2例为18三体综合征，1例为13三体综合征。2例胎儿在羊膜腔穿刺术后死亡。10例活产中，9例脐膨出得到修复，1年生存率为89%。产前诊断似乎并未影响结局。
产前超声检查诊断出86%的外翻性脐膨出病例，并正确报告了67%的相关畸形。羊膜腔穿刺术可能导致1例形态正常的胎儿死亡。
