Roberts J P, Burge D M
Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital.
Arch Dis Child. 1990 Jul;65(7 Spec No):687-9. doi: 10.1136/adc.65.7_spec_no.687.
A review of six years' experience with antenatal diagnosis of abdominal wall defects by ultrasound showed its impact to be limited by poor detection rates. Twenty infants with exomphalos and 20 with gastroschisis were recorded but only 25 (63%) were diagnosed antenatally. The ultrasound false negative rate was higher for exomphalos (35%) than for gastroschisis (22%). No difference was detected in the incidence of associated abnormalities, premature gestation, primary closure rate, or mortality between the antenatally and postnatally diagnosed groups for either exomphalos or gastroschisis. Antenatal diagnosis of gastroschisis has little effect on management but allows parental counselling and in utero transfer. The frequency of concomitant abnormalities in exomphalos profoundly affects prognosis and the detection of these is the major role of antenatal diagnosis in this condition. Failure to detect abdominal wall defects by ultrasound may be a reflection of technique or equipment, but some gastroschisis may be of perinatal onset and not detectable antenatally.
一项关于超声产前诊断腹壁缺损六年经验的回顾显示，其影响因检出率低而受限。记录了20例脐膨出婴儿和20例腹裂婴儿，但仅25例（63%）在产前得到诊断。脐膨出的超声假阴性率（35%）高于腹裂（22%）。脐膨出或腹裂的产前和产后诊断组在相关异常的发生率、早产、一期闭合率或死亡率方面均未检测到差异。腹裂的产前诊断对治疗影响不大，但可进行产前咨询和宫内转运。脐膨出合并异常的频率对预后有深远影响，而检测这些异常是该疾病产前诊断的主要作用。超声未能检测到腹壁缺损可能反映了技术或设备问题，但一些腹裂可能在围产期发病，产前无法检测到。
