Familial occurrence of omphalocele

Prenatal diagnosis of complicated abdominal wall defects

The accurate prenatal diagnosis of anterior abdominal wall defects is important because it affects patient management and prognosis. The pathophysiology of each defect leads to key characteristics that make it possible to differentiate one entity from another. Among these features are the location of the defect in relation to cord insertion, the size and contents of the defect, and the associated anomalies. This article reviews the underlying defects, the characteristic ultrasound findings, the associated anomalies, and the prognosis of simple and complicated abdominal wall defects. The basic features of simple abdominal wall defects (i.e., omphalocele and gastroschisis) were used as the initial points of assessment. A comparison of the different features of these abnormalities and how they differ from one another resulted in the development of criteria that facilitated the understanding of the different ultrasound manifestations of these anomalies.

Etiological study of omphalocele

The epidemiological, teratological and genetic data on 134 index patients with omphalocele (79 isolated and 55 multiple ones) and on 134 matched controls born in Hungary 1970-1976 were studied medical records and by retrospective interview. The stillbirth rate and infant mortality are significantly higher, and there is intrauterine weight retardation and more frequent preterm delivery. The distribution of maternal age-groups shows a 'U-shaped' trend in isolated omphalocele. Spontaneous abortions were significantly higher, particularly in previous pregnancies of mothers of index patients. A striking higher incidence of early and late toxaemia was found in the pregnancies of mothers of the isolated omphalocele group. Sib occurrence was not found in 161 brothers and sisters. Thus amniotic fluid AFP examination is not recommended in subsequent pregnancies. The occurrence of other congenital abnormalities corresponds to 'random' risk.

Omphalocele in half-siblings

A family is described in which half-siblings, a boy and a girl born to unrelated mothers and a phenotypically normal father, were affected with omphalocele. The suggested mode of transmission remains unclear. Prenatal diagnosis to detect an affected fetus should be offered to relatives of omphalocele-affected individuals.