Omphalocele and gastroschisis: prenatal diagnosis and peripartal management - A case analysis of the years 1989-1997 at the Department of Obstetrics and Gynecology, University of Homburg/Saar

Objective: The article presents a retrospective analysis (1989-1997) of the prenatal diagnosis, the course and completion of pregnancy of 26 fetuses w ith omphalocele and 18 fetuses with gastroschisis. Subjects: 44 pregnancies with anterior fetal wall defect diagnosed by prenatal ultrasound, clinical or patho-anatomic examination between 1989 and 1997 at the Department of O bstetrics and Gynecology, University of Homburg/Saar. Results: In 40 of 44 pregnancies (91%) the fetal ventral abdominal wall defect could be detected antenatally with ultrasound. Associated malformations in fetuses with omph alocele were seen in 18 cases (69%), whereas only five fetuses with gastros chisis (28%) had an associated malformation. Nineteen of 26 fetuses (73%) w ith omphalocele had a normal karyotype. Seven of 26 fetuses (27%) with omph alocele had an abnormal karyotype. Eleven fetuses with omphalocele were liv e born, three of them with minor anomalies. Ten babies with omphalocele sur vived. No chromosomal anomalies were detected in fetuses with gastroschisis . There were four gastrointestinal malformations and one lethal associated malformation in fetuses with gastroschisis. There were 15 live born babies with gastroschisis, all of whom have survived. In 20 of 44 cases (45%) with ventral abdominal wall defect oligohydramnios could be detected by ultraso und. In 28 of 44 cases (64%) we found fetal growth retardation <10th percen tile for gestational age. Conclusion: In case of a fetal ventral abdominal wall defect, the detection and appropriate classification of associated fet al anomalies is of great importance for the further course of pregnancy. Fe tal karyotyping should be offered in case of a fetal abdominal wall defect. Early and close prenatal consultation of the neonatologist and the pediatr ic surgeon will favorably influence the perinatal outcome. (C) 1999 Elsevie r Science Ireland Ltd. All rights reserved.