EP07.60: Antenatal diagnosis of omphalocele

Omphalocele is a congenital abdominal wall defect where there is a midline opening at the base of the umbilical cord, allowing abdominal organs to protrude outside the abdominal cavity. It involves herniation through the umbilical ring and is covered by a sac made up of peritoneum, amnion, and Wharton's jelly. This work aims to describe the particularities of antenatal diagnosis and management of omphalocele in a low-resource country. This is a descriptive cross-sectional study that included all omphalocele diagnosed antenatally in our department from 1 January 2016 to December 2020. We report the particularities maternal, ultrasound as well as the management and prognosis of antenatal diagnosis of omphalocele. There were six cases of omphaloceles. Antenatal ultrasound was used to diagnose this malformation. The sensitivity of the diagnosis varied with the stage of pregnancy, being 17% in the first trimester, 71.4% in the second trimester, and 77.8% in the third trimester. Amniocentesis was performed in four pregnancies diagnosed with omphaloceles. This procedure led to the diagnosis of two cases of trisomy 18, one case of trisomy 21, and one case with normal genetic results. This information influenced the decision to terminate the pregnancy in four cases. Antenatal ultrasound identified intestinal complications of the omphalocele in one case, leading to the decision to perform a Caesarean section. Two newborns died, and it was noted that antenatal diagnosis did not improve overall survival. The findings from antenatal ultrasound were confirmed through fetopathological examination in all cases. Antenatal ultrasound is a valuable tool for identifying omphaloceles during pregnancy. The ultrasound allows healthcare professionals to search for associated malformations, helping in the comprehensive evaluation of the condition. Ultrasonographic findings may lead to the indication of Medical Termination of Pregnancy (MGI).