Learning objectives
Recognize the sonographic characteristics and patterns of abdominal wall defects.
Apply a systematic approach in the evaluation of the umbilical cord insertion and its relationship towards the abdominal defects.
Apply a diagnostic algorithm when facing such abnormalities,
so we can differentiate amongst the variety of defects.
Background
Abdominal wall defects (AWDs) correspond to a wide spectrum of congenital defects,
these affect 6.3/10,000 pregnancies.
They represent a heterogeneous group of malformations that share a common feature: the herniation of one or more viscera through the anterior abdominal wall.
Omphalocele and gastroschisis are the most frequent abnormalities,
nevertheless there are less frequent and more complex pathologies,
such as bladder exstrophy,
cloacal exstrophy,
body stalk anomaly,
pentalogy of Cantrell and abdominoschisis due to amniotic bands.
Abdominal wall defects are associated with other congenital abnormalities that...
Findings and procedure details
Obstetric ultrasound is the modality of choice for fetal assessment,
is essential in the diagnosis and classification of abdominal wall defects,
it’s wide and common use has increased the prenatal detection of these abnormalities.
To this date,
most of the AWDs are being detected as soon as 11th – 14th week of pregnancy,
and it has been described that by the 12th week we should be able to detect all cases of omphalocele and gastroschisis.
Sonographic approach
Before we begin the exploration we have to...
Conclusion
Prenatal sonographic findings of abdominal wall defects can be complex and challenging,
requiring from the radiologist familiarity with their presentation patterns as well as a high level of suspicion.
With the use of an algorithmic approach,
starting with the localization of the defect and its relationship with the cord insertion a more precise diagnosis can be made.
This directly affects the decisions taken both pre and postnatally,
having an impact on the proper management of these conditions.
Personal information
Contact details:
Dr.
Eduardo Fuentes Borunda
Resident in training.
Imaging Department,
Hospital Ángeles Lomas.
Vialidad de la Barranca S/N,
52763 Estado de México,
México.
Email:
[email protected]
Dr.
José Arturo Valdez Ramírez
Imaging Department,
Hospital Ángeles Lomas.
Vialidad de la Barranca S/N,
52763 Estado de México,
México.
Email:
[email protected]
Dr.
Luis Eduardo Fiesco Gómez
Imaging Department,
Hospital Ángeles Lomas.
Vialidad de la Barranca S/N,
52763 Estado de México,
México.
Email:
[email protected]
Dr.
Corina Cupa Gálvan
Resident in training.
Imaging Department,
Hospital Ángeles Lomas.
Vialidad de la...
References
El Mhabrech H,
Ben Hmida H,
Charfi H,
Zrig A,
Hafsa C.
(2017).
Prenatal diagnosis of abdominal wall defects.
Archives de Pediatrie.
24(10): 917-924.
Pakdaman R,
Woodward PJ,
Kennedy A.
(2015).
Complex Abdominal Wall Defects: Appearances at Prenatal Imaging.
RadioGraphics.
35: 636-649.
Torres US,
et al.
(2015).
When closure fails: What the Radiologist Needs to Know About the Embryology,
Anatomy,
and Prenatal Imaging of Ventral Body Wall Defects.
Seminars in Ultrasound,
CT and MRI.
36(6): 522-536.
Christison-Lagay ER,
Kelleher CM,
Langer JC.
(2011).
Neonatal abdominal...