TY - JOUR
T1 - Early Diagnosis of Bladder Exstrophy Quantitative Assessment of a Low-Inserted Umbilical Cord
AU - Fishel-Bartal, Michal
AU - Perlman, Sharon
AU - Messing, Baruch
AU - Bardin, Ron
AU - Kivilevitch, Zvi
AU - Achiron, Reuven
AU - Gilboa, Yinon
N1 - Publisher Copyright:
© 2017 by the American Institute of Ultrasound in Medicine.
PY - 2017/9
Y1 - 2017/9
N2 - Objectives—Bladder exstrophy is a rare severe congenital malformation. Early prenatal diagnosis is scarcely described in the literature. Low insertion of the umbilical cord is a constant anatomic feature of bladder exstrophy. The aim of our study was to assess whether early measurements of the umbilical cord insertion–to–genital tubercle length may serve as quantitative measurements for a low-inserted umbilical cord in cases of bladder exstrophy. Methods—The umbilical cord insertion–to–genital tubercle length was prospec-tively measured in all cases referred for a nonvisualized urinary bladder before 18 weeks’ gestation. Final diagnoses were compared with prenatal measurements. Results—Fifteen fetuses were evaluated for a nonvisualized bladder at a mean gesta-tional age of 15.7 weeks (range, 14–17 weeks). Of them, 6 cases were diagnosed with bladder exstrophy, and 9 cases had a normal urinary bladder. All cases with bladder exstrophy had an umbilical cord insertion–to–genital tubercle length below the fifth percentile for gestational age, whereas cases with a normal bladder had a normal measurement. Conclusions—Fetuses with bladder exstrophy have an umbilical cord insertion–to– genital tubercle length below the fifth percentile of the general population. This measurement may serve as a complementary objective sonographic parameter in the prenatal assessment and counseling of cases suspected of having bladder exstro-phy during early pregnancy.
AB - Objectives—Bladder exstrophy is a rare severe congenital malformation. Early prenatal diagnosis is scarcely described in the literature. Low insertion of the umbilical cord is a constant anatomic feature of bladder exstrophy. The aim of our study was to assess whether early measurements of the umbilical cord insertion–to–genital tubercle length may serve as quantitative measurements for a low-inserted umbilical cord in cases of bladder exstrophy. Methods—The umbilical cord insertion–to–genital tubercle length was prospec-tively measured in all cases referred for a nonvisualized urinary bladder before 18 weeks’ gestation. Final diagnoses were compared with prenatal measurements. Results—Fifteen fetuses were evaluated for a nonvisualized bladder at a mean gesta-tional age of 15.7 weeks (range, 14–17 weeks). Of them, 6 cases were diagnosed with bladder exstrophy, and 9 cases had a normal urinary bladder. All cases with bladder exstrophy had an umbilical cord insertion–to–genital tubercle length below the fifth percentile for gestational age, whereas cases with a normal bladder had a normal measurement. Conclusions—Fetuses with bladder exstrophy have an umbilical cord insertion–to– genital tubercle length below the fifth percentile of the general population. This measurement may serve as a complementary objective sonographic parameter in the prenatal assessment and counseling of cases suspected of having bladder exstro-phy during early pregnancy.
KW - bladder exstrophy
KW - early prenatal diagnosis
KW - low-inserted umbilical cord
KW - obstetric ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85045382582&partnerID=8YFLogxK
U2 - 10.1002/JUM.14212
DO - 10.1002/JUM.14212
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AN - SCOPUS:85045382582
SN - 0278-4297
VL - 36
SP - 1801
EP - 1805
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 9
ER -