OB2 Fetal anterior ab wall ch 62

what helps the embryo transform into a cylindrical shape

folding (aids in closing ab wall)

When does folding happen

6th week

what are the three layers of embryonic disk at the fifth week

mesoderm, ectoderm, endoderm

when does fusion of the midline begin and end

begins 7th week, ends 8th week

why do the intestines herniate into umbliic

because the midgut grows faster than the ab cavity

what is the incidence of omphaloceles 

1:400 live births

what is the incidence of gastroschisis

12 per 10:000

what causes a bowel containing ompahlocele

when hernated bowel does not return to abdomen

what are two types of omphaloceles

bowel and liver

will omphalocele or gastroschisis have high AFP

gastroschisis (no membrane)

will bowel or liver gastro have higher risk of anomlies

bowel

what is mortality rate when more than one fetal abnormality exists w/omphalocele

80%

what is mortality rate of omphalocele without other anomalies

10%

what % is risk of recurrence of gastroschisis

3-5%

sono of omphalocele

echogenic, central ab wall defect, evisceration of bowel and/or liver into umbilical cord

what can help distinguish umbilical hernias from liver omphalocele

a normal cord insertion suggests hernia

what may coexist with omphalocele

ascites and hydramnios

what other issues may be associated w/omphalocele

aneuploidy, cardiac, GI, genitourinary, neural tube

what are most common tirsomies associated w/omphaloceles

13 and 18

what umbilical cord finding can be used to differentiate omphalocele from gastroschisis

cord goes through an ompalocele, gastroschisis is to right of cord

what ab wall abnormality should be considered if there is scoliosis and/or cranial defects

limb body wall complex

what ab wall abnormality should be considered if there is amniotic bands

amniotic band syndrome (milder limb body wall complex)

what ab wall abnormality should be considered if there is large omphalocele, diaphragmatic hernia and pericardium, ectopia cordis, sternal cleft

Pentalogy of Cantrell

what ab wall abnormality should be considered if there is a low omphalocele

bladder or cloacal exstrophy

what ab wall abnormality should be considered if there is organomegaly and macroglossia

beckwith-weidemann syndrome

what is gastroschisis

periumbilical defect to right of umbilicus

what is occurrence of gastroschisis

1.75-2.5 : 10:000 live births

Gastroschisis is more common in M or F

M

at what week can gastro be detected by US

12 gestation weeks

sono of gastro

free floating bowel outside ab cavity in area of cord (to right)

what is amniotic band syndrome

rupture of amnion entrapts fetal parts by “sticky” chorion

what are common findings with amniotic band syndrome

facial clefts, asymmetric encephaloceles, clubfoot

what is occurance of amniotic band syndrome

7.8 per 10:000

what do Bechwith-Wiedemann Syndromes have in common

omphalocele, macrglossia, visceromegaly

what is cloacal exstrophy

involves primitive gut and persistent cloaca

what are signs of pentalogy of cantrell

omphalocele, sternal cleft, anterior diaphragmatic hernia, ectopia cordis, defects of diaphragmatic pericardium

what is ectopia cordis

heart on outside of chest through cleft sternum

what are signs of beckwith-wiedemann syndrome

organomegaly, macroglossia, macrosomia, omphalocele

what rare defect occurs early in primitive gut and results in exstrophy of bladder that has two hemi-bladders

cloacal exstrophy

what is usually primary finding w/pentalogy of cantrell

high or superumbilical omphalocele

what’s another name for Turner’s syndrome

45X

what anomolies are most common w/ectopia cordis

omphalocele, cardiovascular malformations, craniofacial defects

what side is limb body wall complex more common

left - 3x more common

how do limb body wall defects happen

when the amnion and chorion fuse and the amnion doesn’t cover the UC normally but extends as a sheet that is continuous w/both body wall and placenta

sono findings of limb body wall defect

large ab and thorax defects, eviscerated organs, bizarre mass entagled w/membranes, short cord adhered to placental membranes

what trisomies are associated w/pentalogy of cantrell

13, 18, 45x