Fetal omphalocele: prenatal US detection of concurrent anomalies and other predictors of outcome.

Forty-six consecutive fetuses with an identified omphalocele were examined with prenatal ultrasound (US) to determine the accuracy of detecting concurrent malformations and to evaluate other possible indicators of fetal outcome. In 43 fetuses with adequate follow-up, 29 (67%) had additional malformations, including 23 with major malformations and six with minor malformations. Thirty-six fetuses (78%) died at termination of pregnancy (n = 23) or spontaneously (n = 13). With the exclusion of pregnancy terminations, fetal mortality was strongly associated with the presence of concurrent malformations, (P less than .001). In 10 surviving fetuses, only three had concurrent malformations, and all were minor. Fetal mortality was also found to be statistically associated with anomalies detected at US (P = .01) and abnormal amniotic fluid volume but was not associated with fetal ascites (P = .64) or omphalocele size (P = .65). Chromosome abnormalities correlated with the absence of liver in the omphalocele sac (P less than .001) and with abnormal amniotic fluid volume (P = .02). Prenatal US can help predict the outcome in fetuses with an omphalocele.