International Journal of Clinical Case Reports 2017, Vol.7, No.16, 67-72
67
Research Report Open Access
The Omphaloceles: Antenatal Diagnosis and Obstetrical Menagement
Ragmoun Houssem
1
, Ajili Abir
1
, Daadoucha Abdrahmen
2
, Benhlima Najeh
3
,
1 Department of Obstetric Gynecology Ibn El Jazzar Hospital, University hospital assistant in gynecology obstetrics, Ibn El Jazzar street, Kairouan, 3100,
Tunisia
2 Department of Radiology Ibn El Jazzar Hospital, University hospital assistant in radiology, Ibn El Jazzar street, Kairouan, 3100, Tunisia
3 Department of Cardiology Ibn El Jazzar Hospital, University hospital assistant in cardiology, Ibn El Jazzar street, Kairouan, 3100, Tunisia
Corresponding author email
International Journal of Clinical Case Reports 2017, Vol.7, No.16 doi
Received: 23 Oct., 2017
Accepted: 27 Nov., 2017
Published: 08 Dec., 2017
Copyright © 2017
Ragmoun et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Ragmoun H., Ajili A., Daadoucha A., and Benhlima N., 2017, The omphaloceles: antenatal diagnosis and obstetrical menagement, International Journal of
Clinical Case Reports, 7(16): 67-72 (doi
Abstract
The omphalocele is a rare malformation. Its frequency is estimated to be 1/5000 births. This malformation results from a
closing defect of the abdominal wall and it’s frequently associated with other chromosomic abnormalities. We reported three new
cases of omphaloceles occurred to 27, 43 and 39 years old patients. The diagnosis by the ultrasound exam was easy and precocious.
A fetal karyotype was performed to all the patients and was constantly abnormal. Therefore, the medical termination of the pregnancy
was practiced to the three patients. On the occasion of those three observations and a literature review, we remind the diagnostic
aspects and the menagement modalities of this congenital malformation.
Keywords
Omphalocele; Parietal defect; Chromosomal aberration; Trisomy 18
Background
The defects of closure of the abdominal wall include a set of parietal malformations. The omphaloceles are the
typical forms of these parietal defects. Their frequency is estimated at 1/5000 deliveries. Thanks to advances in
ultrasound, the antenatal diagnosis of these malformations is made possible from 11-12 weeks of amenorrhea. The
severity of these
pathologies is related to their frequent association with chromosomal or malformative Syndrome
(Mohsni et al., 2008); may therefore be a sign of chromosomal aberrations.
1 Observation
1.1 Observation 1
Ms. T., 27 years old, is a third gesture, nulliparous and having two early miscarriages. She had consulted for
prenatal follow-up of a 3-month pregnancy. The obstetrical examination was normal.
Obstetrical ultrasound showed an active monopetalous pregnancy. Biometrics corresponded to a pregnancy of 12
weeks of amenorrhea. In addition, there was a well-defined round echogenic formation of 13 mm in diameter
attached to the anterior abdominal wall (Figure 1) without any other visible malformation, in particular no
abnormality of the neck. A fetid karyotype on amniotic fluid, made at 15 weeks of amenorrhea had concluded to a
trisomy 21. A medical interruption of the pregnancy had been decided. This was performed with Misoprostol
intravaginally at a rate of 1 tablet every 6 hours. The expulsion took place after the 3rd tablet. The
foeto-pathological examination confirmed the diagnosis of omphalocele and revealed a wide labiopalatine cleft.
1.2 Observation 2
A 43-year-old patient, tenth gesture ninth para, she had no notable particular antecedents or malformations in the
family. She had consulted for excess uterine height at 22 weeks of amenorrhea.
Obstetric ultrasound had shown a single progressive pregnancy. The fetus had a round formation, well limited to 6
cm in diameter with echogenic content and within which we had objectified a small transonic image (digestive
structure). The umbilical cord was inserted on the surface of this formation (Figure 2). On the other hand, there
was manifest hydramnios and extreme shortness of the long bones (Humerus, Femur). The diagnosis retained was
