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The relation between viscero-abdominal disproportion and type of omphalocele closure.

Eur J Obstet Gynecol Reprod Biol. 2014 Oct;181:294-9. doi: 10.1016/j.ejogrb.2014.08.009. Epub 2014 Aug 17.

Peters NC1, Hooft ME2, Ursem NT2, Eggink AJ2, Wijnen RM3, Tibboel D3, Bonsel GJ2, Cohen-Overbeek TE2.
Author information 1Erasmus MC, University Medical Center Rotterdam, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Rotterdam, The Netherlands. Electronic address: n.peters@erasmusmc.nl.2Erasmus MC, University Medic
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
AbstractOBJECTIVE: 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.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:25201609 | http://www.ncbi.nlm.nih.gov/pubmed/25201609

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