Bair J H, Russ P D, Pretorius D H, Manchester D, Manco-Johnson M L
AJR Am J Roentgenol. 1986 Nov;147(5):1047-51. doi: 10.2214/ajr.147.5.1047.
Fetal omphalocele and gastroschisis are congenital defects of the abdominal wall that require prompt surgical management at the time of delivery. To evaluate the role of prenatal sonography in identifying factors that influence prognosis, 24 cases of abdominal-wall defect (16 omphalocele, eight gastroschisis) were reviewed. Sonograms were evaluated for location of umbilical cord insertion, contents of the ventral defect, presence or absence of a covering membrane, fetal ascites, bowel-wall thickening, and coexisting anomalies. Sonographic differentiation between omphalocele and gastroschisis was possible in 18 (75%) of 24 cases. Eighteen patients had congenital defects in addition to the abdominal-wall defect. Associated abnormalities were present in 14 (88%) of 16 fetuses with omphalocele and four (50%) of eight with gastroschisis. Overall survival rate was 50%, excluding six terminated pregnancies. Survival rate was 33% for neonates with omphalocele and 83% for those with gastroschisis. The better prognosis for neonates with gastroschisis appears to reflect the lower frequency of associated congenital anomalies.
胎儿脐膨出和腹裂是腹壁先天性缺陷，分娩时需要及时进行手术处理。为评估产前超声在识别影响预后因素方面的作用，对24例腹壁缺陷病例（16例脐膨出、8例腹裂）进行了回顾性研究。对超声图像评估了脐带插入位置、腹壁缺损内容物、有无覆盖膜、胎儿腹水、肠壁增厚及并存畸形情况。24例中有18例（75%）可通过超声鉴别脐膨出和腹裂。18例患者除腹壁缺陷外还存在先天性缺陷。16例脐膨出胎儿中有14例（88%）及8例腹裂胎儿中有4例（50%）存在相关异常。排除6例终止妊娠的病例后，总体生存率为50%。脐膨出新生儿生存率为33%，腹裂新生儿生存率为83%。腹裂新生儿预后较好似乎反映了相关先天性畸形的发生率较低。
