The relation between viscero-abdominal disproportion and type of omphalocele closure
Objective: To investigate the relation between prenatal ultrasound measurements of viscero-abdominal disproportion and the expected type of postnatal surgical closure of an omphalocele.Study design: Retrospectively, 24 fetuses diagnosed with an isolated omphalocele in the 2nd trimester of pregnancy were selected (period 2003-2013). An image of the axial plane of the abdomen at the level of the defect was retrieved. The ratio of omphalocele circumference to abdominal circumference (OC/AC), and the ratio of defect diameter to abdominal diameter (DD/DA) were calculated. Prognostic outcome was primary closure. Sensitivity and specificity and the corresponding area under the ROC curve of these ratios were calculated as measurements of prognostic accuracy.Results: Primary closure was achieved in 15/24 cases. For the OC/AC-ratio a cut-off value of 0.82 successfully predicted outcome in 23/24 cases with an area under the ROC curve of 0.99. A cut-off value of 0.61 for the DD/DA-ratio successfully predicted type of closure in 20/24 cases with an area under the ROC curve of 0.88. In all cases without eviscerated liver tissue, the defect was primarily closed.Conclusion: In prenatal isolated omphalocele cases, the OC/AC-ratio is better at predicting postnatal surgical closure than the DD/DA-ratio and can be used as a prognostic tool for expected type of closure in the 2nd trimester of pregnancy.
|Keywords||Abdominal wall defect, Counseling, Omphalocele, Perinatal outcome, Prenatal diagnosis|
|Persistent URL||dx.doi.org/10.1016/j.ejogrb.2014.08.009, hdl.handle.net/1765/81494|
|Journal||European Journal of Obstetrics & Gynecology and Reproductive Biology|
Peters, N.C.J, Visser 't Hooft, M.E, Ursem, N.T.C, Eggink, A.J, Wijnen, R.M.H, Tibboel, D, … Cohen-Overbeek, T.E. (2014). The relation between viscero-abdominal disproportion and type of omphalocele closure. European Journal of Obstetrics & Gynecology and Reproductive Biology, 181, 294–299. doi:10.1016/j.ejogrb.2014.08.009