Ch 61 Fetal Anterior Abdominal Wall Flashcards
What are the three most common abdominal wall defects?
- Omphalocele
- Umbilical Hernia
- Gastroschisis
What are some other RARE defects? {5}
Ectopic Cordis, Penology of Cantrell, Limb-Body Wall Complex, Amniotic Band Syndrome, & Bladder/Cloacal Exstrohpy
Abdominal wall defects cause distortion of the normal contour of the _____ or ______ surface of the fetal abdomen.
Ventral or Anterior surface
Does gastroschisis have a membrane?
NO
What is the cord insertion with omphalocele and gastroschisis like?
omphalocele- cord goes through
gastroschisis- is to the right of the cord
Omphaloceles often occurs with _________.
Chromosomal abnormalities
When trying to differentiate gastroschisis from omphaloceles consider…. {5}
- Look for presence of a membrane
- Look at the umbilical cord insertion
- Determine which organs are eviscerated
- Determine if bowel is normal in texture
- Look for other anomalies because omphaloceles often occurs with chromosomal anomalies
Develops when there is a midline defect of the abdominal muscles, fascia, & skin that results in herniation of intra-abdominal structures into the base of the umbilical cord.
Omphalocele
An omphalocele herniation is covered by a membrane that consists of _____ and ______.
Amnion and Peritoneum
AFP with Omphalocele is…
May be slightly elevated or normal {because it is covered by a membrane}
Two types of omphalocele…
- Contains liver in the sac {may or may not contain bowel}
2. Contain a variable amount of bowel WITHOUT liver
Bowel only ompaloceles have a greater risk for chromosomal abnormalities and other anomalies {T/F}
TRUE
Most common chromosomal abnormalities associated with omphaloceles are what?
Trisomy 13 and 18
Consider __________ when scoliosis is found with omphalocele.
Limb-body wall complex
Beckwith-Weidmann syndrome is made up of… {3}
- Macroglossia
- Omphalocele
- Visceromegaly
Herniation of small bowel into amniotic fluid through an open defect {usually an isolated event}
Gastroschisis
What are the two most likely causes of gastroschisis?
- Atrohpy of the RIGHT umbilical VEIN
2. Disruption of the omphalomesenteric ARTERY
Is AFP elevated with gastroschisis?
YES, significantly elevated AFP with gastroschisis
Is gastroschisis more common in males or females?
MALES
Coexisting anomalies are rare with gastroschisis {T/F]
TRUE
With gastroschisis there is mildly dilated bowel and wall thickening. Extremely dilated bowel may suggest _____ or ______.
Infarction or bowel atresia
Severe body wall defects are secondary to ______.
Amniotic band syndrome
Also associated with gastroschisis is… {3}
Hydronephrosis, bladder deviation, and exstrohpy
Rupture of membranes which entangles or entraps fetal parts by “sticky” chorion.
Amniotic band syndrome
Amniotic band syndrome is ______. Occurs in ____ out of ____ births.
RARE. Occurs in 7.8 out of 10,000 births.
_____ is characterized by a defect in the lower abdominal wall and anterior wall of the urinary bladder.
Bladder exstrophy
Bladder exstrophy may include… {4}
- Omphalocele
- Inguinal hernia
- Undistended testes
- Anal problems
Cloacal exstrophy is rare & complex. It occurs ____ in development.
early
_____ results in exstrohpy of the bladder in which two hemibladders are separated by intestinal mucosa
Cloacal exstrophy
Bladder exstrophy is characterized by a defect in the ______ abdominal wall and the _____ wall of the urinary bladder.
Lower abdominal wall and anterior wall of the urinary bladder
Penology of Cantrell is _____.
RARE
What are 5 defects associated with Penology of Cantrell?
- Higher or super umbilical omphalocele
- Ectopia cordis {heart outside the chest}
- Distal sternum defect
- Diaphragmatic hernia
- Diaphragmatic pericardium
abnormal condition in which the brain is located outside the cranium
exencephaly
protrusion of the brain through a cranial fissure
encephalocele
anomaly with large cranial defects, facial cleft, large body wall defects, and limb abnormalities
limb-body wall complex
rare anomaly with five defects: omphalocele, ectopic heart, lower sternum, anterior diaphragm, and diaphragmatic pericardium
pentalogy of Cantrell
The severe form of amniotic band syndrome is ____.
Limb-body wall complex
limb-body wall complex is a _____ condition.
LETHAL
With limb-body wall complex the ____ side body wall defects are 3 times more common than ____ sided defects
Left is 3 times more common than right
Anomalies associated with limb body wall complex … {5}
- Omphalocele
- Severe scoliosis and spinal defects
- Limb anomalies
- Large cranial and facial cleft
- SHORT UMBILICAL CORD
Cloacal bladder is also known as ______ complex
OEIS complex
- O omphalocle
- E exstrohpy
- I imperforate anus
- S spina bifida
The exposed heart presents outside the chest wall through a cleft sternum in ________
Ectopic Cordis
