Comparison of data of complex prenatal examination in cases of fetal congenital diaphragmatic hernia and anterior abdominal wall defects
DOI:
https://doi.org/10.15574/PP.2020.81.20Keywords:
congenital diaphragmatic hernia, omphalocele, gastroschisis, anterior abdominal wall defects, congenital malformations, chromosomal pathologyAbstract
Purpose — to compare data of complex prenatal examination and terms of patients' primary referral to the department of fetal medicine in cases of fetal congenital diaphragmatic hernia, omphalocele and gastroschisis.Patients and methods. Comparison of clinical and anamnestic data, results of ultrasound exams and karyotypes in 200 cases of congenital diaphragmatic hernia in the fetus, 150 cases of omphalocele and 152 cases of gastroschisis in the fetus, which were referred to the department of fetal medicine in 2007–2018.
Results. The youngest age of pregnant women was found in cases of fetal gastroschisis (22.6±4.35); in fetal omphalocele and diaphragmatic hernia women's age was not significantly different (28.2±6.2 and 27.5±5.6). In the omphalocele group, there was significantly higher rate of multiple pregnancies (8.7%). In all three groups, multigravid women had high rate of reproductive losses. The incidence of associated structural malformations and chromosomal abnormalities in omphalocele, diaphragmatic hernia and gastroschisis in the fetus differed significantly, and amounted to 41.3% and 23.5%, 21.3% and 3.5%, and 12.5% and 0%, respectively. In gastroschisis group there was significantly higher incidence of fetal growth restriction (40.1%) and olygohydramnios (18.4%), in diaphragmatic hernia group — higher rate of polyhydramnios (27.5%). Mean terms of primary referral were lowest in omphalocele group (18.46±7.20) and highest in diaphragmatic hernia (27.37±7.20). Analysis of patients' referral in different years showed tendency for increase of early referrals in fetal gastroschisis group after 2010 and in fetal diaphragmatic hernia group in 2017–2018.
Conclusions. Characteristic features in omphalocele group were high incidence of associated structural and chromosomal anomalies, and high rate of multiple pregnancies; for gastroschisis — younger age of pregnant women, high incidence of fetal growth restriction and olygohydramnios; in diaphragmatic hernia group, there was a high rate of associated structural malformations and polyhydramnios, and a moderate level of chromosomal abnormalities. The mean term of the
patients' primary referral was lowest, and the proportion of patients who were referred before 22 weeks was highest is cases of omphalocele in the fetus.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of this Institute. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.
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