scholarly journals Prenatal ultrasound diagnosis of anterior abdominal wall defects in sub Saharan Africa; simple but often missed

2021 ◽  
Vol 9 (8) ◽  
pp. 2252
Author(s):  
Andrew H. Shitta ◽  
Mercy W. Isichei ◽  
Ezekiel D. Dung ◽  
Solomon D. Peter ◽  
Michael B. Ode ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Abdominal Wall ◽  
Detection Rate ◽  
Anterior Abdominal Wall ◽  
Bladder Exstrophy ◽  
Prune Belly Syndrome ◽  
Abdominal Wall Defects ◽  
Cloacal Exstrophy ◽  
Pentalogy Of Cantrell ◽  
Prune Belly

Background: Congenital anterior abdominal wall defects (AAWD) is a spectrum of abdominal wall defects that includes omphalocele, gastroschisis, bladder exstrophy, cloacal exstrophy, prune belly syndrome and pentalogy of Cantrell. Early Prenatal diagnosis of AAWD provides opportunity for abnormal karyotypes screening and planned delivery in a specialized centre. Ultrasound can detect these defects during pregnancy. This study aims to evaluate the detection rate of AAWD during routine obstetric ultrasonography in our region.Methods: A retrospective study of all patients that presented with AAWD to our centre from January 2008 to July 2020. Data included patient’s age, sex, birth weight, diagnosis, resuscitation time, outcome, maternal age, parity and antenatal ultrasound scan (USS) records. Antenatal USS before 12 weeks only, were excluded. Data analysed using excel.Results: Of the 140 with AAWD, 84.29% had omphalocele, 10% gastroschisis, 2.14% prune belly syndrome and 0.71% each with bladder exstrophy, cloacal exstrophy and pentalogy of Cantrell. There were 123 booked pregnancies. Majority (112) had antenatal care elsewhere while 11 attended our Centre. Ultrasonography of 108 pregnancies scanned at12 weeks or beyond, had 4 confirmed prenatal diagnosis of AAWD. All done in our centre. Mean gestational age at diagnosis was 24weeks. Outcome was rupture1 (25%) and 25% mortality (prenatally diagnosed) and 51.92% mortality for patients with missed diagnosis.Conclusions: Our obstetric ultrasound detection rate of AAWD is very low. There is a need for improvement in training to improve perinatal care of these defects.

The Mechanism of Prune Belly Syndrome Development: A Sonographic Sequential Assessment

2020 ◽  
Vol 36 (6) ◽  
pp. 594-603
Author(s):  
Raham Bacha ◽  
Syed Amir Gilani ◽  
Iqra Manzoor ◽  
Iftikhar Ahmad ◽  
Syed Faisal Hanan Shah
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Outlet Obstruction ◽  
Normal Karyotype ◽  
Abdominal Distention ◽  
Ductus Venosus ◽  
Prune Belly Syndrome ◽  
Prune Belly ◽  
Antenatal Sonography ◽  
Urinary Tract Malformations

Prune belly syndrome is a rare disorder characterized by the absence of anterior abdominal wall muscles, bilateral cryptorchidism, and urinary tract malformations. The aim of this case study was to illustrate the developmental sequelae of prune belly syndrome, acquired through a series of antenatal sonography. A 20-year-old woman visited a diagnostic medical sonography center for an obstetrical sonogram. Her fetus was diagnosed with megacystis at 15 weeks’ gestation. The mother returned for repeated appointment and to observe fetal changes during the development of prune belly syndrome. First, the megacystis, hydroureter, and hydronephrosis were noted followed by hazy ascitic and amniotic fluid. The hemodynamics were altered in the umbilical artery, middle cerebral artery, and ductus venosus. Subsequently, the pressure was neutralized, but it was observed after birth that the newborn had cryptorchidism, a distended abdomen with wrinkled wall, and absent right kidney. In conclusion, prune belly syndrome could be caused by megacystis due to bladder outlet obstruction in otherwise normal karyotype fetuses. Megacystis leads to hydroureter, hydronephrosis, and abdominal distention. The persistent abdominal distention gives rise to the underdevelopment of anterior abdominal wall muscles and cryptorchidism.

Prenatal diagnosis and management of anterior abdominal wall defects in the West of Scotland

1993 ◽  
Vol 13 (2) ◽  
pp. 111-115 ◽  
Author(s):  
R. J. Morrow ◽  
M. J. Whittle ◽  
Margaret B. McNay ◽  
P. A. M. Raine ◽  
A. A. M. Gibson ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defects ◽  
The West ◽  
Diagnosis And Management

scholarly journals Modern Management of the Exstrophy-Epispadias Complex

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Brian M. Inouye ◽  
Ali Tourchi ◽  
Heather N. Di Carlo ◽  
Ezekiel E. Young ◽  
John P. Gearhart
Keyword(s):  
Quality Of Life ◽  
Abdominal Wall ◽  
Surgical Outcomes ◽  
Surgical Complications ◽  
Anterior Abdominal Wall ◽  
Bladder Exstrophy ◽  
Urinary Continence ◽  
Cloacal Exstrophy ◽  
Genitourinary System

The exstrophy-epispadias complex is a rare spectrum of malformations affecting the genitourinary system, anterior abdominal wall, and pelvis. Historically, surgical outcomes were poor in patients with classic bladder exstrophy and cloacal exstrophy, the two more severe presentations. However, modern techniques to repair epispadias, classic bladder exstrophy, and cloacal exstrophy have increased the success of achieving urinary continence, satisfactory cosmesis, and quality of life. Unfortunately, these procedures are not without their own complications. This review provides readers with an overview of the management of the exstrophy-epispadias complex and potential surgical complications.

scholarly journals Prune belly syndrome: a case of early prenatal diagnosis

2017 ◽  
Vol 6 (4) ◽  
pp. 1652
Author(s):  
Suvidhi Kamra ◽  
Unmesh Santpur ◽  
Nidhi Puri ◽  
Neetu Pippet
Keyword(s):  
Prenatal Diagnosis ◽  
Abdominal Wall ◽  
First Trimester ◽  
Congenital Disorder ◽  
Urogenital Tract ◽  
Prune Belly Syndrome ◽  
Prune Belly ◽  
Rare Congenital Disorder ◽  
First Trimester Of Pregnancy

Prune belly syndrome is a rare congenital disorder typically characterized by a triad of malformation of the urogenital tract, defect of abdominal wall musculature, and cryptorchidism. The condition is generally incompatible with life as infants born with this syndrome are either stillborn or die within the first few weeks of life. The present case is of a fetus presenting with prune bell syndrome, detected in first trimester of pregnancy.

scholarly journals Management of cavernous abdominal wall defects post radical cystectomy in adult exstrophy complex

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-226076
Author(s):  
Prashant Kumar ◽  
Rishi Nayyar ◽  
Amlesh Seth ◽  
Deepti Gupta
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Bladder Exstrophy ◽  
Rectus Muscle ◽  
Anterolateral Thigh Flap ◽  
Abdominal Wall Defects ◽  
Cloacal Exstrophy ◽  
Local Skin ◽  
Anterolateral Thigh ◽  
Total Reconstruction

The exstrophy–epispadias complex represents a spectrum of genitourinary malformations ranging from simple glanular epispadias to an overwhelming multisystem defect, cloacal exstrophy. Neonatal total reconstruction of bladder exstrophy–epispadias complex is the treatment of choice. An adult patient presenting with untreated exstrophy is very rare. Malignant transformation, commonly adenocarcinoma, in such cases is a known complication due to mucosal metaplasia of urothelium. Management in such cases necessitates a radical surgical procedure that often results in a massive defect in the anterior abdominal wall. Providing a cover for such defects is a challenging task for the reconstructive surgeon. Local skin flaps and wide mobilisation of the rectus muscle are the usually employed techniques for closure of such defects. However, these may be inadequate in extremely large defects such as those encountered in our patients. We, hereby, describe our technique of closure of the abdominal wall defect using a pedicled anterolateral thigh flap.

Antenatal diagnosis and perinatal care of anterior abdominal wall defects

1995 ◽  
Vol 7 (3) ◽  
pp. 109-127 ◽  
Author(s):  
Hratch L Karamanoukian ◽  
Stuart J O'Toole ◽  
Philip L Glick
Keyword(s):  
Parenteral Nutrition ◽  
Abdominal Wall ◽  
Antenatal Diagnosis ◽  
Anterior Abdominal Wall ◽  
Wide Spectrum ◽  
Perinatal Care ◽  
Postoperative Management ◽  
Abdominal Wall Defects ◽  
Anaesthetic Care ◽  
Prognostic Implications

Improvements in anaesthetic care and postoperative management over the last two decades have significantly improved survival of neonates with ventral abdominal wall defects, from a dismal 47% in 1971, to 96% for both gastroschisis and isolated omphalocele in two recent series. This increased survival has generally been attributed to result from improvements in the pre and postoperative management of these fragile neonates. Specifically, the routine use of total parenteral nutrition, and staged repairs for cases with severe “viscero-abdominal disproportion” have been implicated in a decreased incidence of sepsis, morbidity and mortality. In addition, an appreciation of the wide spectrum of anomalies uniquely associated with gastroschisis and omphalocele have helped improve survival, as each has unique pathophysiologic features that have prognostic implications for the fetus before, during and after delivery.

Total Abdominal Wall Reconstruction in the Prune Belly Syndrome

1986 ◽  
Vol 136 (1 Part 2) ◽  
pp. 282-285 ◽  
Author(s):  
Richard M. Ehrlich ◽  
Malcolm A. Lesavoy ◽  
Richard N. Fine
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Prune Belly Syndrome ◽  
Prune Belly
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