Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2017

11.11.2016 | Maternal-Fetal Medicine

Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome

verfasst von: Nina Diemon, Katrin Funke, Mareike Möllers, Kerstin Hammer, Johannes Steinhard, Cristina Sauerland, Volker Müller, Walter Klockenbusch, Ralf Schmitz

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate the relationship between the thorax diameter and defect diameter of giant omphaloceles as a predictor for fetal outcome.

Methods

In a retrospective study, 17 fetuses with isolated giant omphaloceles were included for evaluation. The anterior–posterior thorax diameter and the defect diameter were measured from ultrasound images. For analysis, the thorax-to-head ratio (T/HC), the defect diameter-to-head ratio (DD/HC), and the quotient of the defect diameter and the thorax diameter (DD/T) were calculated. The days of ventilation (t ventilation), the duration until hospital discharge (t hospital), and the type of treatment were recorded as outcome parameters.

Results

No relationship was found between the calculated ratios (T/HC, DD/HC, or DD/T) and neither t hospital (r = −0.418, p = 0.095; r = −0.153, p = 0.556; and r = −0.023, p = 0.929; respectively) nor t ventilation (r = −0.391, p = 0.121; r = 0.041, p = 0.875; and r = 0.121, p = 0.645, respectively). The type of postnatal treatment was not associated with the three calculated ratios or t hospital (r = 0.155, p = 0.553; r = 0.019, p = 0.942; and r = 0.012, p = 0.965; r = −0.009, p = 0.973, respectively). In 53% of cases, t hospital was delayed due to additional and independent postnatal complications.

Conclusion

Thorax diameter or defect diameter of giant omphaloceles is not predictive for fetal outcome. The perinatal care of these abdominal wall defects still remains a multidisciplinary challenge, but the outcome of giant omphaloceles is favorable at experienced centers.
Literatur
1.
Zurück zum Zitat Christison-Lagay ER, Kelleher CM, Langer JC (2011) Neonatal abdominal wall defects. Semin Fetal Neonatal Med 16:164–172CrossRefPubMed Christison-Lagay ER, Kelleher CM, Langer JC (2011) Neonatal abdominal wall defects. Semin Fetal Neonatal Med 16:164–172CrossRefPubMed
3.
Zurück zum Zitat Prefumo F, Izzi C (2014) Fetal abdominal wall defects. Best Pract Res Clin Obstet Gynaecol 28:391–402CrossRefPubMed Prefumo F, Izzi C (2014) Fetal abdominal wall defects. Best Pract Res Clin Obstet Gynaecol 28:391–402CrossRefPubMed
4.
Zurück zum Zitat Kouame BD, Odehouri Koudou TH, Yaokreh JB, Sounkere M, Temberly S, Yapo KGS, Boka R, Koffi M, Dieth AG, Ouattara O, da Silva A, Dick R (2014) Outcome of conservative treatment of giant omphaloceles with dissodic 2% aqueous eosin: 15 years’ experience. Afr J Paediatr Surg 11:170–173CrossRefPubMed Kouame BD, Odehouri Koudou TH, Yaokreh JB, Sounkere M, Temberly S, Yapo KGS, Boka R, Koffi M, Dieth AG, Ouattara O, da Silva A, Dick R (2014) Outcome of conservative treatment of giant omphaloceles with dissodic 2% aqueous eosin: 15 years’ experience. Afr J Paediatr Surg 11:170–173CrossRefPubMed
5.
Zurück zum Zitat Peters NCJ, Visser ‘t Hooft ME, Ursem NTC, Eggink AJ, Wijnen RMH, Tibboel D, Bonsel GJ, Cohen-Overbeek TE (2014) The relation between viscero-abdominal disproportion and type of omphalocele closure. Eur J Obstet Gynecol Reprod Biol 181:294–299CrossRefPubMed Peters NCJ, Visser ‘t Hooft ME, Ursem NTC, Eggink AJ, Wijnen RMH, Tibboel D, Bonsel GJ, Cohen-Overbeek TE (2014) The relation between viscero-abdominal disproportion and type of omphalocele closure. Eur J Obstet Gynecol Reprod Biol 181:294–299CrossRefPubMed
6.
Zurück zum Zitat Montero FJ, Sompson LL, Brady PC, Miller RS (2011) Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele. Am J Obstet Gynecol 205:284.e1–284.e7CrossRef Montero FJ, Sompson LL, Brady PC, Miller RS (2011) Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele. Am J Obstet Gynecol 205:284.e1–284.e7CrossRef
7.
Zurück zum Zitat Kleinrouweler CE, Kuijper CF, van Zalen-Sprock MM, Mathijssen IB, Bilardo CM, Pajkrt E (2011) Characteristics and outcome and the omphalocele circumference/abdominal circumference ratio in prenatally diagnosed fetal omphalocele. Fetal Diagn Ther 30:60–69CrossRefPubMed Kleinrouweler CE, Kuijper CF, van Zalen-Sprock MM, Mathijssen IB, Bilardo CM, Pajkrt E (2011) Characteristics and outcome and the omphalocele circumference/abdominal circumference ratio in prenatally diagnosed fetal omphalocele. Fetal Diagn Ther 30:60–69CrossRefPubMed
8.
Zurück zum Zitat Kiyohara MY, Brizot ML, Liao AW, Francisco RPV, Tannuri ACA, Krebs VLJ, Zugaib M (2014) Should we measure fetal omphalocele diameter for prediction of perinatal outcome? Fetal Diagn Ther 35:44–50CrossRefPubMed Kiyohara MY, Brizot ML, Liao AW, Francisco RPV, Tannuri ACA, Krebs VLJ, Zugaib M (2014) Should we measure fetal omphalocele diameter for prediction of perinatal outcome? Fetal Diagn Ther 35:44–50CrossRefPubMed
9.
Zurück zum Zitat Tassin M, Descriaud C, Elie C, Houfflin Debarge V, Dumez Y, Perrotin F, Benachi A (2013) Omphalocele in the first trimester: prediction of perinatal outcome. Prenat Diagn 33:497–501CrossRefPubMed Tassin M, Descriaud C, Elie C, Houfflin Debarge V, Dumez Y, Perrotin F, Benachi A (2013) Omphalocele in the first trimester: prediction of perinatal outcome. Prenat Diagn 33:497–501CrossRefPubMed
10.
Zurück zum Zitat Kamata S, Usui N, Sawai T, Nose K, Fukuzawa M (2008) Prenatal detection of pulmonary hypoplasia in giant omphaloceles. Pediatr Surg Int 24:107–111CrossRefPubMed Kamata S, Usui N, Sawai T, Nose K, Fukuzawa M (2008) Prenatal detection of pulmonary hypoplasia in giant omphaloceles. Pediatr Surg Int 24:107–111CrossRefPubMed
11.
Zurück zum Zitat Hershenson MB, Brouillette RT, Klemka L, Raffensperger JD, Poznanski AK, Hunt CE (1985) Respiratory insufficiency in newborns with abdominal wall defects. J Pediatr Surg 20:348–353CrossRefPubMed Hershenson MB, Brouillette RT, Klemka L, Raffensperger JD, Poznanski AK, Hunt CE (1985) Respiratory insufficiency in newborns with abdominal wall defects. J Pediatr Surg 20:348–353CrossRefPubMed
12.
Zurück zum Zitat Argyle JC (1989) Pulmonary hypoplasia in infants with giant abdominal wall defects. Pediatr Pathol 9:43–55CrossRefPubMed Argyle JC (1989) Pulmonary hypoplasia in infants with giant abdominal wall defects. Pediatr Pathol 9:43–55CrossRefPubMed
13.
Zurück zum Zitat Headley BM, McDougall PN, Stokes KB, Dewan PA, Dargaville PA (2001) Left-lung-collapse bronchial deformation in giant omphaloceles. J Pediatr Surg 36:846–850CrossRefPubMed Headley BM, McDougall PN, Stokes KB, Dewan PA, Dargaville PA (2001) Left-lung-collapse bronchial deformation in giant omphaloceles. J Pediatr Surg 36:846–850CrossRefPubMed
14.
Zurück zum Zitat Danzer E, Hedrick HL, Rintoul NE, Siegle J, Adzick NS, Panitch HB (2012) Assessment of early pulmonary function abnormalities in giant omphaloceles survivors. J Pediatr Surg 47:1811–1820CrossRefPubMed Danzer E, Hedrick HL, Rintoul NE, Siegle J, Adzick NS, Panitch HB (2012) Assessment of early pulmonary function abnormalities in giant omphaloceles survivors. J Pediatr Surg 47:1811–1820CrossRefPubMed
15.
Zurück zum Zitat Tsakayannis DE, Zurakowski D, Lillehei CW (1996) Respiratory insufficiency at birth: a predictor of mortality for infants with giant omphaloceles. J Pediatr Surg 31:1088–1091CrossRefPubMed Tsakayannis DE, Zurakowski D, Lillehei CW (1996) Respiratory insufficiency at birth: a predictor of mortality for infants with giant omphaloceles. J Pediatr Surg 31:1088–1091CrossRefPubMed
16.
Zurück zum Zitat Merz E, Wellek S, Bahlmann F, Weber G (1994) Sonographische Normkurven des fetalen knöchernen Thorax und der fetalen Lunge. Geburtshilfe Frauenheilkd 55:77–82CrossRef Merz E, Wellek S, Bahlmann F, Weber G (1994) Sonographische Normkurven des fetalen knöchernen Thorax und der fetalen Lunge. Geburtshilfe Frauenheilkd 55:77–82CrossRef
17.
Zurück zum Zitat Snijders RJM, Nicolaides KH (1994) Fetal biometrie at 14–40 weeks’ gestation. Ultrasound Obstet Gynecol 4:34–48CrossRefPubMed Snijders RJM, Nicolaides KH (1994) Fetal biometrie at 14–40 weeks’ gestation. Ultrasound Obstet Gynecol 4:34–48CrossRefPubMed
18.
Zurück zum Zitat Fleiss JL (1999) Reliability of measurement. The design and analysis of clinical experiments. Wiley, New York, pp 1–32CrossRef Fleiss JL (1999) Reliability of measurement. The design and analysis of clinical experiments. Wiley, New York, pp 1–32CrossRef
19.
Zurück zum Zitat Schwaitzberg SD, Pokorny WJ, McGill CW, Harberg FJ (1982) Gastroschisis and omphalocele. Am J Surg 144(6):650–654CrossRefPubMed Schwaitzberg SD, Pokorny WJ, McGill CW, Harberg FJ (1982) Gastroschisis and omphalocele. Am J Surg 144(6):650–654CrossRefPubMed
20.
Zurück zum Zitat Bauseler A, Funke K, Möllers M, Hammer K, Steinhard J, Borowski M, Müller V, Klockenbusch W, Schmitz R (2016) Outcome of fetuses with gastroschisis after modification of prenatal management strategies: prenatal management and outcome of gastroschisis. Arch Gynecol Obstet 294:239–243CrossRefPubMed Bauseler A, Funke K, Möllers M, Hammer K, Steinhard J, Borowski M, Müller V, Klockenbusch W, Schmitz R (2016) Outcome of fetuses with gastroschisis after modification of prenatal management strategies: prenatal management and outcome of gastroschisis. Arch Gynecol Obstet 294:239–243CrossRefPubMed
21.
Zurück zum Zitat Ali Z, Schmidt P, Dodd J, Jeppesen DL (2013) Bronchopulmonary dysplasia: a review. Arch Gynecol Obstet 288:325–333CrossRefPubMed Ali Z, Schmidt P, Dodd J, Jeppesen DL (2013) Bronchopulmonary dysplasia: a review. Arch Gynecol Obstet 288:325–333CrossRefPubMed
Metadaten
Titel
Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome
verfasst von
Nina Diemon
Katrin Funke
Mareike Möllers
Kerstin Hammer
Johannes Steinhard
Cristina Sauerland
Volker Müller
Walter Klockenbusch
Ralf Schmitz
Publikationsdatum
11.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4236-1

Weitere Artikel der Ausgabe 2/2017

Archives of Gynecology and Obstetrics 2/2017 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.