Bence Christina M, Wagner Amy J
Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Transl Pediatr. 2021 May;10(5):1461-1469. doi: 10.21037/tp-20-94.
Abdominal wall defects are common congenital anomalies with the most frequent being gastroschisis and omphalocele. Though both are the result of errors during embryologic development of the fetal abdominal wall, gastroschisis and omphalocele represent unique disorders that have different clinical sequelae. Gastroschisis is generally a solitary anomaly with postnatal outcomes related to the underlying integrity of the prolapsed bowel. In contrast, omphalocele is frequently associated with other structural anomalies or genetic syndromes that contribute more to postnatal outcomes than the omphalocele defect itself. Despite their embryological differences, both gastroschisis and omphalocele represent anomalies of fetal development that benefit from multidisciplinary and translational approaches to care, both pre- and postnatally. While definitive management of abdominal wall defects currently remains in the postnatal realm, advancements in prenatal diagnostics and therapies may one day change that. This review focuses on recent advancements, novel techniques, and current controversies related to the prenatal diagnosis and management of gastroschisis and omphalocele.
腹壁缺损是常见的先天性异常,其中最常见的是腹裂和脐膨出。虽然两者都是胎儿腹壁胚胎发育过程中出现错误的结果,但腹裂和脐膨出是具有不同临床后果的独特病症。腹裂通常是一种孤立性异常,其出生后的预后与脱垂肠管的潜在完整性有关。相比之下,脐膨出常与其他结构异常或遗传综合征相关,这些对出生后的预后影响比脐膨出缺陷本身更大。尽管腹裂和脐膨出在胚胎学上存在差异,但两者均代表胎儿发育异常,无论产前还是产后,多学科和转化医学的护理方法都对其有益。虽然目前腹壁缺损的确定性治疗仍在出生后阶段,但产前诊断和治疗的进展可能有朝一日会改变这种情况。本综述重点关注与腹裂和脐膨出的产前诊断和管理相关的最新进展、新技术和当前争议。