Abstract

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

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