omphalocele Archives - Revista Brasileira de Ginecologia e Obstetrícia

Purpose: to evaluate the prognosis of fetal omphalocele after prenatal diagnosis. Methods: fifty-one cases with prenatal diagnosis of fetal omphalocele were divided into three groups: group 1, isolated omphalocele; group 2, omphalocele associated with structural abnormalities and normal karyotype; group 3, omphalocele with abnormal karyotype. The data were analyzed for overall survival rate and postsurgery survival, considering associated malformations, gestational age at delivery, birth weight and size of omphalocele. Results: group 1 corresponded to 21% (n = 11), group 2, 55% (n = 28) and group 3,24% (n = 12). All of Group 3 died, and trisomy 18 was the most frequent chromosomal abnormality. The survival rate was 80% for group 1 and 25% for group 2. Sixteen cases underwent surgery (10 isolated and 6 associated), 81% survived (8 isolated and 5 associated). The median birth weight was 3,140 g and 2,000 g for survivals and non-survivals after surgery, respectively (p = 0.148), and the corresponding gestational age at delivery was 37 and 36 weeks (p = 0.836). The ratio of omphalocele/abdominal circumference decreased with gestation, 0.88 between 25-29 weeks and 0.65 between 30-35 weeks (p = 0.043). The size of omphalocele was not significantly different between the 3 groups (p = 0.988), and it was not associated to postsurgery prognosis (p = 0.553). Conclusion: the overall and postsurgery survival rates were 25 and 81%, respectively. Associated malformations were the main prognostic factor in prenatally diagnosed omphaloceles, since they are associated with prematurity and low birth weight.