Chen C P, Liu F F, Jan S W, Sheu J C, Huang S H, Lan C C
Departments of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
Am J Perinatol. 1996 Aug;13(6):355-61. doi: 10.1055/s-2007-994356.
We retrospectively reviewed 27 cases of omphalocele and 15 cases of gastroschisis occurring among 62, 572 deliveries between 1987 and 1994. All cases had undergone prenatal sonographic examinations at a mean gestational age of 28 weeks. In cases of omphalocele, 59.3% (16/27) of fetuses were associated with multiple malformations and 16% (4/25) had chromosomal abnormalities. Among the 4 cases with an abnormal karyotype, three cases were associated with extracorporeal livers and two cases were associated with umbilical cord cysts. Prenatal ultrasound examinations during the second and third trimesters were able to detect 66.7% (18/27) of the cases of omphalocele and 66.7% (10/15) of the cases of gastroschisis. Failure in correctly diagnosing abdominal wall defects by prenatal ultrasound occurred mostly in cases associated with small defects, ruptured omphalocele, multiple fetal anomalies, intrauterine fetal death, twin pregnancies, or cases referred in late gestation. A comparison of perinatal data between omphalocele and gastroschisis reveals fetuses with omphalocele carry higher risks of associated malformations, chromosomal abnormalities, prematurity, and neonatal death. Although fetuses with gastroschisis have higher incidences of oligohydramnios and small for gestational age, the fetal prognosis after pediatric surgery is good.
我们回顾性分析了1987年至1994年间62572例分娩中发生的27例脐膨出和15例腹裂病例。所有病例均在平均孕周28周时接受了产前超声检查。在脐膨出病例中，59.3%（16/27）的胎儿伴有多发畸形，16%（4/25）有染色体异常。在4例核型异常的病例中，3例与体外肝脏有关，2例与脐带囊肿有关。孕中期和孕晚期的产前超声检查能够检测出66.7%（18/27）的脐膨出病例和66.7%（10/15）的腹裂病例。产前超声未能正确诊断腹壁缺损大多发生在与小缺损、破裂的脐膨出、多发胎儿畸形、宫内胎儿死亡、双胎妊娠或孕晚期转诊的病例中。脐膨出和腹裂围产期数据的比较显示，脐膨出胎儿伴有相关畸形、染色体异常、早产和新生儿死亡的风险更高。虽然腹裂胎儿羊水过少和小于胎龄的发生率较高，但小儿手术后胎儿预后良好。
