Fetal Karın Ön Duvarı Defektlerinin Prenatal Tanısı ve Neonatal SonuçLarının Retrospektif Olarak İncelenmesi

Abstract

Fetal anterior abdominal wall defects cause serious morbidity and mortality and their prenatal diagnosis are quite important. The better diagnosis of the pathogenesis of the diseases has ensured more cautious pregnancy follow-up and improvement of postnatal management. The aim of our study is to examine obsestric and neonatal outcomes of the pregnancies which were followed at our clinic with diagnosis of gastroschisis and omphalocale. A total of 47 prenatally diagnosed patients were included in our study. Seventeen of the fetuses were diagnosed with gastroschisis, while 30 fetuses were diagnosed with omphalocale. Median maternal age was 24 years in gastroschisis group and 30 years in omphalocale group. Karyotype analysis was performed for 4 fetuses in the gastroschisis group and results were found to be normal karyotype for all. On the other hand, in omphalocale group, karyotype analysis was performed on 15 fetuses and chromosomal abnormalities were found in 10 fetuses (33.3%). Associated anomalies were detected in 17.6% of the fetuses with gastroschisis, whilst the ratio was determined as 46.7% in omphalocale group. In gastroschisis group, 94,1% of the patients were delivered. However, termination of pregnancy was performed in 56.7% of the omphalocele group. Median gestational week at birth in the gastroschisis group was 36.5 weeks, while the mentioned duration in omphalocale group was 38 weeks. Median duration for hospital stay of the neonates were 29 days and 9 days in gastroschisis and omphalocale groups, respectively. Median duration of postoperative parenteral nutrition was determined as 18.5 days in gastroschisis group, while the mentioned duration in omphalocale group was 9 days. Median duration before postoperative oral nutrition in gastroschisis group was 11 days, while the mentioned duration in omphalocale group was 5 days. There was a statistically significant difference between the both groups in terms of these variables. In conclusion, early diagnosis is important for the close follow-up of the patients and for the planning of giving birth or termination since gastroschisis and omphalocale are fetal anterior abdominal wall defects that can be diagnosed via prenatal diagnosis. In case of fetal anterior abdominal wall defect diagnosis, it is important to evaluate chromosomal abnormalities and associated anomalies for the physicians. The survival rate of the infants with gastroschisis was 62.5%; while the rate was 53.8% for the infants with omphalocale following the surgical operations in postnatal period. At the same time, long term hospitalization and intensive care unit adminisration may be necessitated. Antenatal care, birth and surgical operations for the newborn in the postnatal period should be performed by an experienced tertiary medical center.