Prenatal ultrasonographic diagnosis of the anterior abdominal wall abnormalities in omphalocele-exstrophy-imperforate anus-spinal defects complex

doi:10.3877/cma.j.issn.1672-6448.2018.05.007

Abstract

Abstract:

Objective

To Summarize the prenatal ultrasonographic characteristics of abdominal wall deformity in omphalocele-exstrophy-imperforate anus-spinal defects (OEIS).

Methods

The prenatal ultrasonic characteristics of anterior abdominal wall abnormalities in 46 fetuses with OEIS complex were retrospectively analyzed and compared with the autopsy examination results.

Results

The 46 fetuses with OEIS were confirmed by follow-up, among which 26 fetuses had detailed autopsy informations. The prenatal ultrasound performance of fetal abdominal wall malformation included absence bladder, low abdominal wall umbilical cord insertion, and lower abdominal wall bulging between the two legs. The bulgings were divided into 5 types according to the prenatal ultrasound characteristics: (1) Predominantly cystic bulging in the lower anterior abdominal wall in 12 fetuses. (2) The abdominal bulging under the umbilical with exstrophy in 22 fetuses, of which were ″elephant trunk-like″ in 13 fetuses. (3) The lower abdominal wall bulgings in the root of the umbilical cord in 6 fetuses. (4) Large gastroschisis malformation in 3 fetuses. (5) Omphalocele with exstrophy in 3 fetuses.

Conclusions

The prenatal ultrasonographic characteristics of abdominal wall deformity in OEIS complex are diverse and complex. The predominantly cystic bulging is the early prenatal sonographic characteristic of the OEIS syndrome and abdominal bulging under the umbilical with exstrophy is the most common prenatal ultrasonic characteristic of OEIS complex.

Key words: Ultrasonography, prenatal, Fetal, Anterior abdominal wall, Abnormalities, Omphalocele-exstrophy-imperforate anus-spinal defects

Junhong Huang, Xiaohong Yang, Xinlin Chen, Sheng Zhao, Dan Lu, Fan Yang, Xiuqin Ji. Prenatal ultrasonographic diagnosis of the anterior abdominal wall abnormalities in omphalocele-exstrophy-imperforate anus-spinal defects complex[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(05): 359-365.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.05.007

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I05/359

Figures/Tables 7

References 13

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妊娠类型	检查例数	腹壁异常	伴发其他异常
单胎	38（38）	38（38）	38（38）
双胎	6（12）^a	6（7）^a	6（7）
三胎	1（3）	1（1）	1（1）
合计	45（53）	45（46）	45（46）

妊娠类型	检查例数	腹壁异常	伴发其他异常
单胎	38（38）	38（38）	38（38）
双胎	6（12）^a	6（7）^a	6（7）
三胎	1（3）	1（1）	1（1）
合计	45（53）	45（46）	45（46）

膨出物特征	囊性为主混合性膨出物	脐下腹壁膨出伴外翻	下腹壁脐带根部膨出	大的腹裂畸形	脐膨出伴外翻
腹壁脐插入位置	难以分辨	低位	极低位，达耻骨联合	探查困难	稍低位
膨出物与脐带关系	分辨不清	紧邻脐带根部下方	脐带根部	分辨不清	脐带根部
膨出物性质	囊性为主	实性为主	实性为主	实性为主	实性为主
膨出物形状	不规则	呈驼峰样尖端朝下	长圆形欠规则	不规则	圆形或类圆形
膨出物朝向	向骶尾部突起	向会阴部突起	朝腹壁前方略向下	不规则	朝腹壁前方
膨出物包膜	探查困难，大部分无	似有完整包膜	不完整	无	完整
膨出物下方伴外翻	无	有，象鼻征13例	无	分辨不清	有
膨出物与脐血流关系	无回声表面走行	膨出物上缘走行	包绕整个膨出物	无	包绕整个膨出物

膨出物特征	囊性为主混合性膨出物	脐下腹壁膨出伴外翻	下腹壁脐带根部膨出	大的腹裂畸形	脐膨出伴外翻
腹壁脐插入位置	难以分辨	低位	极低位，达耻骨联合	探查困难	稍低位
膨出物与脐带关系	分辨不清	紧邻脐带根部下方	脐带根部	分辨不清	脐带根部
膨出物性质	囊性为主	实性为主	实性为主	实性为主	实性为主
膨出物形状	不规则	呈驼峰样尖端朝下	长圆形欠规则	不规则	圆形或类圆形
膨出物朝向	向骶尾部突起	向会阴部突起	朝腹壁前方略向下	不规则	朝腹壁前方
膨出物包膜	探查困难，大部分无	似有完整包膜	不完整	无	完整
膨出物下方伴外翻	无	有，象鼻征13例	无	分辨不清	有
膨出物与脐血流关系	无回声表面走行	膨出物上缘走行	包绕整个膨出物	无	包绕整个膨出物

腹壁异常类型	例数（%）	孕妇年龄（岁，±s）	检出孕周（周，±s）	病理检查［例（%）］^a
囊性为主混合性膨出	12（26.1）	22~33（27.9±3.7）	11.4~18.3（13.4±1.9）	10（83.3）
脐下腹壁膨出物伴外翻	22（47.8）	20~34（26.5±3.6）	20.3~30.5（24.3±3.0）	8（36.4）
下腹壁脐带根部膨出	6（13.0）	23~27（27.8±4.0）	16.4~22.0（18.4±2.0）	4（66.7）
大的腹裂畸形	3（6.5）	24~27（25.3±1.5）	16.2~31.4（22.5±7.9）	2（66.7）
脐膨出伴外翻	3（6.5）	25~30（27.3±2.5）	21.4~34.4（26.7±6.8）	2（66.7）

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