Omphalocele - Diagnosis

Laboratory studies.
Alpha-fetoprotein is a protein produced by fetal tissues, fetal serum and released into the mother. Maximum concentration is reached in week 14 of pregnancy. It is also found in amniotic fluid, urine and cerebrospinal fluid. It serves to transport hormones necessary for the normal development of the fetus during pregnancy and other substances necessary for its physiological developments. It is used as a tumor marker during pregnancy and in adult life. In pregnancy it increased values ​​associated with various congenital anomalies, including omphalocele.
Acetylcholinesterase is an enzyme that can also be increased in the presence of omphalocele. This can be detected by chromatography.Chromosomal tests are indicated for children and other associated malformations of the digestive system and other organs and systems.
Imaging tests.
Omphalocele diagnosed when an ultrasound to demonstrate an abdominal mass in excess of previous abdominal midline. Table consists of internal organs herniated printrun defect at the umbilical ring. Its diameter is 2. 5-5 cm. The table is smooth and contains viscera abdominal, liver, spleen, and stomach inetstinele.Peritoneum that covers may break. This is not always visible.Wharton jelly layers can be detected peritonelului wallpaper.
The umbilical cord is attached to the top mass hernias, umbilical vein which can be observed. The umbilical cord can be expanded at junction with mass protrudes. Fetal ascites is common and is seen in the hernia sac. Oligohidraminosul Polihidraminosul and rarely may be present. When the diameter measurements omphalocele, its diameter is greater than 60% compared to the transverse diameter of the abdomen, the liver contains.
Diagnostic ultrasound is a sensitive method of omphalocele, with the advantage that can be performed quickly and repeatedly without risk to mother and fetus. Definitive diagnosis of omphalocele is possible after 12 weeks of pregnancy, when not doing comfuzia with physiologic bowel herniation.
MRI allows assessment of fetal anatomy and ultrasound can be seconded before surgery for certain conditions. It can detect abnormalities and other fetal organs and systems congeitale of omphalocele associated with, such as cardiovascular and neural tube.
Diagnostic accuracy is superior to echography in some cases of brain malformation due to high resolution for soft tissues and global view of complex fetal defects. MRI is considered safe for fetal development. No test conducted so far not demonstrated teratogenic or other effects edverse during pregnancy.
Differential diagnosis is made with the following conditions: gastroschisis, umbilical hernia, extrofia bladder Pentalog toracoabdominala of Cantrell, extrofia cloacal, complex multiple hemangiomas, pseudo-omphalocele.