Beyond the womb: prenatal MRI's prognostic abilities for morbidity and mortality in neonates with omphaloceles.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-05-16 DOI:10.1038/s41372-025-02321-1

Krishna Manohar, Fikir M Mesfin, Jessica Belchos, Brandon P Brown, Cameron Colgate, Lava Timsina, Joshua Brown, Rachel Tullar, Brian W Gray

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引用次数: 0

Abstract

Background: Managing omphaloceles poses challenges in prenatal consultation and perinatal care. We hypothesized that specific fetal MRI findings could predict morbidity and mortality in these patients.

Methods: We analyzed fetal MRI studies demonstrating omphaloceles from 2006 to 2022 and conducted a retrospective review of medical records. Predictor variables were correlated with outcomes using univariate and multivariate analyses, and Receiver Operating Characteristic (ROC) curves were optimized with Youden's J statistic.

Results: Among 46 omphalocele patients, 89% survived to birth, with an overall mortality rate of 37%. Significant predictors of mortality included stomach/spleen herniation, severe anomalies, omphalocele-associated syndromes, membrane rupture, lower observed/expected total fetal lung volume (O/E TFLV), and increased percentage of liver herniation. The need for deferred repair correlated with liver/stomach herniation and "giant-omphalocele." ROC analysis identified mortality cut points at O/E TFLV < 42% and liver herniation >77%, while deferred repair was indicated at liver herniation >51%.

Conclusion: This study identified prenatal MRI findings associated with mortality and deferred repair, aiding in risk prediction and family counseling.

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子宫外：产前MRI对脐膨出新生儿发病率和死亡率的预测能力。

背景：脐膨出的管理提出了产前咨询和围产期护理的挑战。我们假设特定的胎儿MRI结果可以预测这些患者的发病率和死亡率。方法：我们分析了2006年至2022年显示脐膨出的胎儿MRI研究，并对医疗记录进行了回顾性回顾。采用单因素和多因素分析将预测变量与结果进行相关性分析，并采用约登J统计量优化受试者工作特征（ROC）曲线。结果：46例脐膨出患者中，89%存活至出生，总死亡率为37%。死亡率的重要预测因素包括胃/脾疝、严重异常、脐膨出相关综合征、膜破裂、观察/预期总胎肺体积（O/E TFLV）降低和肝疝百分比增加。延期修复的需要与肝/胃疝和“巨大脐膨出”相关。ROC分析发现，O/E TFLV的死亡率降低点为77%，而肝疝的延迟修复为51%。结论：本研究确定了产前MRI发现与死亡率和延迟修复相关，有助于风险预测和家庭咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.