A Parenting & kids forum. ParentingBanter.com

If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below.

Go Back   Home » ParentingBanter.com forum » misc.kids » Pregnancy
Site Map Home Authors List Search Today's Posts Mark Forums Read Web Partners

Suspected omphalocele at 8 weeks



 
 
Thread Tools Display Modes
  #1  
Old May 26th 05, 06:35 PM
Zara
external usenet poster
 
Posts: n/a
Default Suspected omphalocele at 8 weeks

I went for my first ultrasound last monday, at 8 weeks, and the doctor
found out a big mass coming out of the baby's tummy, and they suspect
it can be omphalocele. It is more or less as big as the tummy itself.

I'm going back at 10 weeks for the second u/s, and if it's still there
they'll probably offer to do a CVS.

Is there anyone out there that saw this so early, and when did they
confirm the diagnosis?
And especially, did anyone see this, and then it disappeared and their
baby was fine?

Thanks!

  #2  
Old May 26th 05, 06:52 PM
Phoebe & Allyson
external usenet poster
 
Posts: n/a
Default

Zara wrote:

I went for my first ultrasound last monday, at 8 weeks, and the doctor
found out a big mass coming out of the baby's tummy, and they suspect
it can be omphalocele.


http://www.pedisurg.com/PtEduc/Omphalocele.htm "As the fetus grows in
pregnancy, the intestines grow and get longer and project from the
abdomen into the umbilical cord. This growth is taking place from the
sixth to the tenth week of pregnancy. Normally the intestines return
rapidly into the abdomen by the eleventh week of pregnancy. If this
fails to happen, an omphalocele is present."

I also found a PubMed cite from 2000 (link contains nasty stuff almost
certainly not relevant to you; if I were you, I'd be disinclined to read
it -
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract)
discussing an omphalocele diagnosed at 11 weeks, and the authors say
"this is one of the earliest diagnosis of [...] omphalocele."

IMHO, both 8 and 10 weeks are too early for a confirmed diagnosis.

Phoebe

  #3  
Old May 26th 05, 07:06 PM
Ericka Kammerer
external usenet poster
 
Posts: n/a
Default

Zara wrote:

I went for my first ultrasound last monday, at 8 weeks, and the doctor
found out a big mass coming out of the baby's tummy, and they suspect
it can be omphalocele. It is more or less as big as the tummy itself.

I'm going back at 10 weeks for the second u/s, and if it's still there
they'll probably offer to do a CVS.

Is there anyone out there that saw this so early, and when did they
confirm the diagnosis?
And especially, did anyone see this, and then it disappeared and their
baby was fine?


Hmm...my understanding, which may be out of date, is that
it's not really an omphalocele until and unless the intestines
fail to go back into the abdomen in the 10-12th weeks--and most
of the time they do. Some even go back later than 12-18 weeks.
It seems like maybe 10 weeks is a bit on the early side to be
rechecking. On the other hand, since omphalocele is associated
with a higher risk of chromosomal defects, doing CVS gives you
the earliest heads up as to whether something more serious is
going on, but it comes at a risk and seeing this mass at 10 weeks
isn't necessarily a great indicator that there will be an
omphalocele.
Bottom line: it's common for something like this seen
at 8 weeks to disappear, and it's certainly possible that one
detected at 12-18 weeks will disappear (especially if it's not
a very large one).

Best wishes,
Ericka

  #4  
Old May 26th 05, 07:22 PM
Zara
external usenet poster
 
Posts: n/a
Default

Thanks Phoebe.
The doctor also says we can only wait for now and that the final
diagnosis can be done probably aroud 12 weeks.
However, I read an article that says that if the mass is larger than 7
mm in diameter, the diagnosis can be made earlier as they have never
seen a physiological midgut herniation go away when it's so big (the
physiological midgut herniation is the normal part of the embryo
development for which the intestines get out of the tummy, rotate and
then go back in by 12 weeks). So that's what is really worrying me,
that it's so big. Plus, the doctor seemed really concerned.

Pleae let me know if there is someone who has seen this and then it
disappeared.

  #5  
Old May 26th 05, 07:29 PM
Jamie Clark
external usenet poster
 
Posts: n/a
Default

Zara,
My son, Nathan James, had a giant omphalocele. We discovered it first via
the AFP coming back wacky, and then an u/s at 18 weeks. It was as large as
his belly, if not slightly larger. The majority of his large intestine,
part of his stomach, and part of his liver where inside the omphalocele. We
never had an early u/s, so I have no idea if it would have shown up then or
not. I have heard of tons of women having early u/s, due to infertility
treatments, and have never heard of any of them showing anything that could
have been called an omphalocele, even in the early stages. I sincerely hope
that the intestines go back inside around the 10-12 week mark, as they are
supposed to. The CVS may not give you any details...we did an amnio when we
found Nathan's problem, and it came back clean. Although "most"
omphaloceles are connected with chromosomal anomalies, not all of them are.
In the end, after multiple consultations with various specialists, an
echocardiogram, multiple u/s's, and lots of hard thinking, we decided to end
the pregnancy at 24 weeks via labor and delivery.

Coincidentally, 6 years before we had Nathan, my sister had a baby diagnosed
with an omphalocele via u/s. Although the omphalocele seemed pretty big,
the baby was otherwise healthy, and my sister decided to continue the
pregnancy. When the baby was born, the doctors said that it didn't look as
large as they thought. They were able to push everything back into the hole
and sew it up, and now my niece Kinsey is 11 years old and has an inch long
scar near her belly button. During our ordeal, I talked to my sister a lot,
and tried as best I could to "compare" the omphaloceles, to see if there was
a chance that Nathan's outcome would be as good. Unfortunately, it seemed
that Nathan's omphalocele was larger than Kinsey's, and he also had some
heart issues, a possibly curved spine, and some blood pooling in his
abdomen, so his prognosis was much worse.

Sending hugs your way, and prayers that your baby is okay.
--

Jamie
Earth Angels:
Taylor Marlys, 1/3/03 -- My Big Girl, who goes pee pee and poo poo on the
potty!
Addison Grace, 9/30/04 -- The Crawler, who is officially crawling and has
her first two teeth!

Check out the family! -- www.MyFamily.com, User ID: Clarkguest1, Password:
Guest
Become a member for free - go to Add Member to set up your own User ID and
Password

"Zara" wrote in message
oups.com...
I went for my first ultrasound last monday, at 8 weeks, and the doctor
found out a big mass coming out of the baby's tummy, and they suspect
it can be omphalocele. It is more or less as big as the tummy itself.

I'm going back at 10 weeks for the second u/s, and if it's still there
they'll probably offer to do a CVS.

Is there anyone out there that saw this so early, and when did they
confirm the diagnosis?
And especially, did anyone see this, and then it disappeared and their
baby was fine?

Thanks!



  #6  
Old May 27th 05, 04:04 PM
Zara
external usenet poster
 
Posts: n/a
Default

So... did anybody see this mass at 8 weeks, and their doctor was
worried about it?

  #7  
Old May 27th 05, 05:34 PM
Ericka Kammerer
external usenet poster
 
Posts: n/a
Default

Zara wrote:

So... did anybody see this mass at 8 weeks, and their doctor was
worried about it?


Most people aren't having u/s at 8 weeks, so most wouldn't
even know. And keep in mind that at 8 weeks, you're talking
about only an inch long embryo. U/s can be a marvelous thing,
but this is still very early and very small. I know you can't
help worrying--I'd be doing the same--but I just don't think
you are going to get high quality information for a while yet.
You can think about a lot of if-then scenarios, but you just
don't have the information yet to know anything with any
specificity in your particular situation, and when you add
in that not so many women have 8 week u/s, even the collective
experience on m.k.p might not be a particularly good barometer.
There may even be situations where a mass was detected, but
not even mentioned because it was just assumed to be a normal
midgut herniation.

I noticed that there are some online omphalocele support groups.
It might be that among the population of women who've had
babies with omphaloceles, some had early u/s and did or didn't
find anything suspicious at that time.

Here are some things you might find useful:

Radiology. 2004 Jul;232(1):191-5.
Fetal omphalocele detected early in pregnancy: associated anomalies
and outcomes.

Blazer S, Zimmer EZ, Gover A, Bronshtein M.

Department of Neonatology, Rambam Medical Center and Faculty of
Medicine, Technion-Israel Institute of Technology, 8 Ha'Aliyah St, Haifa
35254, Israel.

PURPOSE: To detect omphalocele and associated anomalies at
ultrasonography (US) early in pregnancy and to describe the outcomes in
fetuses with isolated and nonisolated omphalocele. MATERIAL AND METHODS:
Fetal endovaginal US was performed in 43,896 pregnant women at 12-16
weeks gestation. The women found to have fetal omphalocele were offered
an amniocentesis to determine the fetal karyotype. For parents who
decided to continue the pregnancy, repeat targeted transabdominal fetal
US was performed at 20-24 weeks gestation. Additional follow-up US
examinations performed until delivery were recommended. Postnatal
pediatric examinations were performed in all of these fetuses. For the
pregnancies in which no anomaly was detected at early US, the women were
advised to undergo repeat US at about 24 weeks gestation for the
detection of late-manifesting fetal anomalies. For pregnancies in which
the baby was not delivered at the authors' affiliated hospital, the
woman, her obstetrician, and her pediatrician were asked to inform the
authors of any detected anomaly. RESULTS: Omphalocele was visualized at
US in 38 fetuses, who were categorized into two groups. One group
consisted of 22 (58%) fetuses with associated structural anomalies.
According to the karyotype determined for 18 of these fetuses, 11 of
them also had chromosomal anomalies. The pregnancy was terminated at the
parents' request in 19 of these 22 cases. There were two cases of missed
abortion, and a small omphalocele in one fetus disappeared at 21 weeks
gestation. The second group consisted of 16 (42%) fetuses with a normal
karyotype and an omphalocele as an isolated US finding. In eight of
these fetuses, the omphalocele disappeared at 20-24 weeks gestation and
no defect was seen at delivery. In six other fetuses, omphalocele was
identified at delivery. There was one case each of missed abortion and
pregnancy termination. There were no false-negative diagnoses of
omphalocele. CONCLUSION: Isolated omphalocele diagnosed during the early
stages of gestation typically has a good prognosis. In cases of a small
defect, the anomaly may disappear later in the pregnancy. Copyright
RSNA, 2004

From
http://www.emedicine.com/radio/topic483.htm:

"Results of recent ultrasonographic studies suggest that in
differentiating between normal physiologic herniation and a concern for
omphalocele one should note that physiologic midgut herniation should
not exceed 7 mm in diameter and that physiologic herniation should not
be apparent in fetuses with a crown-rump length greater than 44 mm."

"Physiologic herniation occurs at 10-13 weeks' gestation. The best
method for differentiating this from an omphalocele is repeat sonography
after 15 weeks' menstrual age. A large defect with liver exteriorized
indicates an omphalocele at any gestational age."

"When the ratio of the diameter of the omphalocele to the transverse
diameter of the abdomen is less than 60%, the lesion usually contains
bowel and not liver. The relative size of the omphalocele may decrease
during pregnancy."

"False Positives/Negatives: An anterior abdominal-wall mass has a wide
differential diagnosis. Problems may exist in differentiating between a
midline omphalocele and physiologic midgut herniation in early pregnancy
and the bowel herniation of gastroschisis."

" * One group assessing the accuracy of routine ultrasonography in
detecting fetal anterior abdominal-wall defects found a detection rate
of 60% with a false-positive rate of 5.3% (Walkinshaw, 1992).

o In this study, sonographic examination was performed
between 16 and 22 weeks in an unselected population.

o Fetuses with gastroschisis were incorrectly assigned as
having exomphalos in 14.7% of cases recognized before 22 weeks."





  #8  
Old June 8th 05, 10:18 PM
Zara
external usenet poster
 
Posts: n/a
Default

Thanks everybody for your support.

I went for another U/S on Monday, and the defect is still there. The
doctor said there is still a 30% chance that it'll go away, but to
start thinking of what we want to do if it doesn't.
She booked me for another U/S in two weeks, and for the CVS the same
day, should we want to do that. The CVS has a 1% risk of miscarriage,
plus it only gives you some answers about some specific genetic
problems that could be associated with the abdominal wall defect, but
it doesn't exclude many others. She said they only can be sure of what
else (if anything) is wrong by looking at the baby when he's born.
DH and I are just so torn right now.

  #9  
Old June 8th 05, 11:00 PM
Jamie Clark
external usenet poster
 
Posts: n/a
Default

Zara,
I'm sorry that it still seems to be there. You and your dh and baby will be
in my thoughts and prayers. Whatever you do, you have my support. If you
do consider terminating, please check out
http://www.aheartbreakingchoice.com/ . There are tons of people there who
can help support you.

Hugs.
--

Jamie
Nathan James, AHC, 3/98, giant omphalocele and heart defects
8 other little angels
Earth Angels:
Taylor Marlys, 1/3/03 -- My Big Girl, who goes pee pee and poo poo on the
potty!
Addison Grace, 9/30/04 -- The Standing Fool, who climbs to standing every
chance she gets!

Check out the family! -- www.MyFamily.com, User ID: Clarkguest1, Password:
Guest
Become a member for free - go to Add Member to set up your own User ID and
Password

"Zara" wrote in message
oups.com...
Thanks everybody for your support.

I went for another U/S on Monday, and the defect is still there. The
doctor said there is still a 30% chance that it'll go away, but to
start thinking of what we want to do if it doesn't.
She booked me for another U/S in two weeks, and for the CVS the same
day, should we want to do that. The CVS has a 1% risk of miscarriage,
plus it only gives you some answers about some specific genetic
problems that could be associated with the abdominal wall defect, but
it doesn't exclude many others. She said they only can be sure of what
else (if anything) is wrong by looking at the baby when he's born.
DH and I are just so torn right now.



 




Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
misc.kids FAQ on Breastfeeding Past the First Year [email protected] Info and FAQ's 0 February 28th 05 06:26 AM
misc.kids FAQ on Breastfeeding Past the First Year [email protected] Info and FAQ's 0 December 29th 04 06:26 AM
misc.kids FAQ on Breastfeeding Past the First Year [email protected] Info and FAQ's 0 July 29th 04 05:16 AM
misc.kids FAQ on Breastfeeding Past the First Year [email protected] Info and FAQ's 0 June 28th 04 07:41 PM
misc.kids FAQ on Breastfeeding Past the First Year [email protected] Info and FAQ's 0 December 15th 03 10:42 AM


All times are GMT +1. The time now is 12:37 PM.


Powered by vBulletin® Version 3.6.4
Copyright ©2000 - 2024, Jelsoft Enterprises Ltd.
Copyright ©2004-2024 ParentingBanter.com.
The comments are property of their posters.