Can perinatal outcomes of fetal omphalocele be improved at a tertiary center in South China?

J Matern Fetal Neonatal Med. 2022 Dec;35(25):8409-8411. doi: 10.1080/14767058.2021.1974837. Epub 2021 Sep 8.

Abstract

Objective: To assess the efficacy of positive feedback closed-loop management system (PFCMS) protocol in influencing parents' decision about pregnancy continuation in pregnancies diagnosed with omphalocele.

Methods: This was a retrospective cohort study of patients who were diagnosed with fetal omphalocele prior to 20 weeks' gestation by ultrasound and were referred to Fetal Care Center at a mainland Chinese medical center during an 11-year period. Two management strategies were offered during the two stages of the study period: a single consultant with a routine protocol and a multidisciplinary support team with PFCMS, respectively. We analyzed the two protocols influencing parents' decision about pregnancy continuation.

Results: Forty-nine patients diagnosed with fetal omphalocele were included in this study. In Group A including 16 patients with routine protocol during the first stage of the study period, the majority opted for termination, and only five continued the pregnancy. In Group B including 33 patients with PFCMS during the second stage of the study period, less than one third chose TOP, and 23 ended in live births. There was a significantly lower TOP rate in patients treated with the PFCMS protocol.

Conclusion: The PFCMS protocol may be an efficient approach in managing pregnancies complicated by omphalocele, which may help in preventing unnecessary pregnancy terminations.

Keywords: Fetal omphalocele; multidisciplinary consultation; prenatal diagnosis; ultrasound.

MeSH terms

  • China / epidemiology
  • Female
  • Fetus
  • Hernia, Umbilical* / diagnostic imaging
  • Hernia, Umbilical* / therapy
  • Humans
  • Pregnancy
  • Prenatal Care
  • Retrospective Studies
  • Ultrasonography, Prenatal