van de Geijn E J, van Vugt J M, Sollie J E, van Geijn H P
Academisch Ziekenhuis Vrije Universiteit, afd. Verloskunde en Gynaecologie, Amsterdam.
Ned Tijdschr Geneeskd. 1991 Nov 23;135(47):2235-8.
Twenty-seven cases of foetal abdominal wall defects are described, diagnosed prenatally by means of real-time ultrasonography in the period 1 January 1980-31 December 1989, in the hospital of the Free University of Amsterdam. In 17 out of 20 (85%) cases with omphalocele there were additional abnormalities, mainly chromosomal defects (41%), cardiac (25%) and genitourinary (25%) malformations. In gastroschisis, associated structural anomalies occurred in 57% (4/7). No chromosomal defects were found in the group with gastroschisis. Intrauterine foetal death occurred in 10 cases. Seven pregnancies were electively aborted because of association with an anomaly incompatible with postnatal life. One child died at two months. Six children (4 with omphalocele, 2 with gastroschisis) were successfully treated surgically. When ultrasonography demonstrates a foetal abdominal wall defect detailed sonographic examination is recommended to exclude additional malformations. In case of omphalocele prenatal chromosome analysis is indicated. Delivery in a tertiary care center is recommended. Elective caesarean section does not appear justified.
本文描述了1980年1月1日至1989年12月31日期间在阿姆斯特丹自由大学医院通过实时超声产前诊断的27例胎儿腹壁缺陷病例。在20例脐膨出病例中，有17例（85%）存在其他异常，主要是染色体缺陷（41%）、心脏（25%）和泌尿生殖系统（25%）畸形。在腹裂病例中，57%（4/7）存在相关结构异常。腹裂组未发现染色体缺陷。10例发生宫内胎儿死亡。7例因伴有与出生后生活不相容的异常而选择性流产。1名儿童在2个月时死亡。6名儿童（4例脐膨出，2例腹裂）成功接受了手术治疗。当超声显示胎儿腹壁缺陷时，建议进行详细的超声检查以排除其他畸形。对于脐膨出，建议进行产前染色体分析。建议在三级护理中心分娩。选择性剖宫产似乎没有必要。
