Characteristics associated with abdominal wall defects in neonates

Characteristics associated with abdominal wall defects in neonates

Location of defectRight of umbilicus or lateral to cordMidline including umbilicus and umbilical ring
Covering membraneNoYes
Size of defect3 to 5 cm4 to 10 cm
Umbilical cord insertionBody wall at normal locationOmphalocele membrane
Herniated abdominal organsSmall bowelBowel and sometimes liver, occasionally other organs
Associated major congenital anomaliesRareFrequent (50%-70%)
Associated congenital syndromeRareCommon (approximately 30%)
Intestinal atresia10% to 20%Rare
Prognostic factorsCondition of bowelAssociated anomalies
MortalityLess than 5%20% to 30%
Bowel appearanceMatted, foreshortened, edematous, exudativeNormal
MalrotationOften presentOften present
Small abdominal wall cavityPresentPresent
Postoperative gastrointestinal dysfunctionProlonged ileus commonOften normal
Global incidenceIncreasingStable
Maternal ageYounger than 20 yearsAverage
Surgical managementUrgentNot urgent with intact membrane
Mean gestational age at spontaneous delivery34 to 36 weeks’ gestationTerm or near term
Male to female ratio1:11.5:1
Elevated maternal alpha fetoprotein levelsAlmost always markedly elevatedOften elevated


Data from Ledbetter DJ: Congenital abdominal wall defects and reconstruction in pediatric surgery: gastroschisis and omphalocele. Surg Clin North Am. 92(3):713-27, 2012, Table 1; Walther AE et al: Newborn abdominal wall defects. In: Wyllie R et al, eds: Pediatric Gastrointestinal and Liver Disease. 5th ed. Philadelphia, PA: Elsevier; 2016:654-65.e4, Table 58-1; Gamba P et al: Abdominal wall defects: prenatal diagnosis, newborn management, and long-term outcomes. Semin Pediatr Surg. 23(5):283-90, 2014, Table 3; Prefumo F et al: Fetal abdominal wall defects. Best Pract Res Clin Obstet Gynaecol. 28(3):391-402, 2014, Table 1; and Christison-Lagay ER et al: Neonatal abdominal wall defects. Semin Fetal Neonatal Med. 16(3):164-72, 2011, Table 1.


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