Vaginal Delivery in Cases of Prenatally Diagnosed Omphalocele: Feasibility and Outcomes.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2025-06-29 DOI:10.1002/pd.6843

H Heinrich, D Kunne, J P M Derikx, E van Leeuwen, I H Linskens, E Pajkrt

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引用次数: 0

Abstract

Objective: This study aimed to assess outcomes of fetuses with prenatally detected omphalocele and the frequency of successful vaginal delivery in pregnancies with suspected non-lethal omphalocele and intended active neonatal management and its impact on neonatal outcome.

Method: Prenatally diagnosed omphalocele cases in Amsterdam UMC from January 2007 to January 2023 were selected. Ultrasound data including the omphalocele circumference/abdominal circumference (OC/AC) ratio were collected and perinatal data were obtained for liveborn cases.

Results: A total of 225 cases were included, with a live birth rate of 20.0% (45/225). Of the suspected non-lethal cases with active neonatal management, vaginal delivery was pursued in 78.9% (30/38), of which 76.7% (23/30) succeeded. The rate of giant omphaloceles did not differ significantly between vaginal and caesarean deliveries, nor did the rate of nulliparity, maximum OC/AC ratio, extracorporeal liver on prenatal ultrasound and successful primary closure. Intrapartum sac rupture occurred in 13.0% (3/23) of successful vaginal deliveries, which was not associated with the OC/AC ratio and in none of the cases with cesarean section. Birth dystocia of the abdomen occurred in none of the cases.

Conclusion: In cases of intended vaginal delivery, 76.7% of vaginal deliveries succeeded, even in cases with giant omphalocele, of which the majority did not experience perinatal complications. Therefore, vaginal delivery appears to be a feasible option in cases with prenatally diagnosed omphaloceles.

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阴道分娩的情况下，产前诊断脐膨出：可行性和结果。

目的：本研究旨在评估产前检测出脐膨出的胎儿的结局、怀疑非致死性脐膨出的孕妇阴道分娩成功率和有意的新生儿积极管理及其对新生儿结局的影响。方法：选择2007年1月至2023年1月在阿姆斯特丹UMC进行产前诊断的脐膨出病例。超声数据包括脐膨出围/腹围（OC/AC）比，并获得活产病例的围产期数据。结果：共纳入225例，活产率为20.0%（45/225）。在新生儿积极管理的疑似非致死性病例中，78.9%（30/38）采用阴道分娩，其中76.7%（23/30）成功分娩。大脐膨出率在阴道分娩和剖宫产之间无显著差异，无产率、最大OC/AC比、产前超声检查体外肝脏和初次闭合成功也无显著差异。成功阴道分娩的13.0%（3/23）发生产时囊破裂，与OC/AC比值无关，剖宫产无一例。所有病例均未发生腹部分娩难产。结论：阴道分娩的成功率为76.7%，即使是巨大脐膨出，也没有出现围产儿并发症。因此，在产前诊断为脐膨出的病例中，阴道分娩似乎是一个可行的选择。

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

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling