Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 18 , ISSUE 1 ( January-March, 2024 ) > List of Articles


Three-dimensional Ultrasound, HDlive, HDlive Silhouette, and SlowflowHD Features of Fetal OEIS Complex in the First-trimester of Pregnancy

Toshiyuki Hata, Miyu Konishi, Aya Itoh, Riko Takayoshi, Takahito Miyake, Naoki Okimoto, Yasuo Nakahara

Keywords : Fetus, First trimester, HDlive, HDlive silhouette, Omphalocele-exstrophy-imperforate anus-spinal defects complex, SlowflowHD, Three-dimensional ultrasound orthogonal rendering

Citation Information : Hata T, Konishi M, Itoh A, Takayoshi R, Miyake T, Okimoto N, Nakahara Y. Three-dimensional Ultrasound, HDlive, HDlive Silhouette, and SlowflowHD Features of Fetal OEIS Complex in the First-trimester of Pregnancy. Donald School J Ultrasound Obstet Gynecol 2024; 18 (1):1-5.

DOI: 10.5005/jp-journals-10009-2009

License: CC BY-NC 4.0

Published Online: 28-03-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Objective: To demonstrate first-trimester ultrasound features of omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex using three-dimensional (3D) ultrasound orthogonal rendering, HDlive, HDlive silhouette, and SlowflowHD. Case description: A 34-year-old pregnant Japanese woman, G2, P1, was referred to our ultrasound clinic at 12 weeks and 6 days of gestation because of a suspected fetal extra-abdominal tumor. Two-dimensional (2D) sonography revealed an extra-abdominal tumor containing the stomach, liver, and intestines. 3D ultrasound orthogonal rendering revealed bladder exstrophy beneath the omphalocele and suspected thoracolumbar vertebral deformity. Ductus venosus blood flow velocity waveform was normal. HDlive and HDlive silhouette depicted bladder exstrophy beneath the omphalocele. HDlive silhouette revealed the stomach, liver, and intestines inside the tumor. SlowflowHD demonstrated characteristic intratumoral vascularity vascularity. OEIS complex was strongly suspected. Chromosome analysis using amniocentesis at 16 weeks and 4 days revealed a karyotype of 46, XY. Absent bladder and absent target signs were noted in the second- and third-trimester fetal ultrasound scans. Magnetic resonance imaging (MRI) in the third trimester revealed omphalocele with pubic symphysis diastasis and lower abdominal wall defect. At 38 weeks and 6 days of gestation, a cesarean section was performed, resulting in a male newborn weighing 2686 gm and with a height of 45.4 cm. Apgar scores were 7 (1 minute) and 8 (5 minutes), and umbilical artery (UA) blood pH was 7.318. OEIS complex was confirmed after birth. Conclusion: Three-dimensional (3D) ultrasound orthogonal rendering, HDlive, HDlive silhouette, and SlowflowHD may provide additional useful information about the unique characteristics of the OEIS complex in the first trimester of pregnancy.

PDF Share
  1. Hurwitz RS, Manzoni GA, Ransley PG, et al. Cloacal exstrophy: a report of 34 cases. J Urol 1987;138(4 Pt 2):1060–1064. DOI: 10.1016/s0022-5347(17)43502-6
  2. Schemm S, Gembruch U, Germer U, et al. Omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex associated with increased nuchal translucency. Ultrasound Obstet Gynecol 2003;22(1):95–97. DOI: 10.1002/uog.126
  3. Aneja K, Gandhi S, Deka JB, et al. Pattern recognition of abdominal vasculature on color Doppler in the fetus as a tool for early diagnosis of bladder exstrophy in the first and early-second trimester: initial observations. Indian J Radiol Imaging 2022;32(3):403–407. DOI: 10.1055/s-0042-1754363
  4. Girz BA, Sherer DM, Atkin J, et al. First-trimester prenatal sonographic findings associated with OEIS (omphalocele-exstrophy-imperforate anus-spinal defects) complex: a case and review of the literature. Am J Perinatol 1998;15(1):15–17. DOI: 10.1055/s-2007-993891
  5. Wax JR, Pinette MG, Smith R, et al. First-trimester prenatal sonographic diagnosis of omphalocele-exstrophy-imperforate anus-spinal defects complex. J Clin Ultrasound 2009;37(3):171–174. DOI: 10.1002/jcu.20520
  6. Liang YL, Kang L, Tsai PY, et al. Prenatal diagnosis of fetal omphalocele by ultrasound: a comparison of two centuries. Taiwan J Obstet Gynecol 2013;52(2):258–263. DOI: 10.1016/j.tjog.2013.04.018
  7. Lakasing L, Cicero S, Davenport M, et al. Current outcome of antenatally diagnosed exomphalos: an 11 year review. J Pediatr Surg 2006;41(8):1403–1406. DOI: 10.1016/j.jpedsurg.2006.04.015
  8. van Zalen-Sprock RM, Vugt JM, van Geijn HP. First-trimester sonography of physiological midgut herniation and early diagnosis of omphalocele. Prenat Diagn 1997;17(6):511–518.
  9. Caradeux J, Martinez-Portilla RJ, Basuki TR, et al. Risk of fetal death in growth-restricted fetuses with umbilical and/or ductus venosus absent or reversed end-diastolic velocities before 34 weeks of gestation: a systematic review and meta-analysis. Am J Obstet Gynecol 2018;218(2S):S774–S782.e21. DOI: 10.1016/j.ajog.2017.11.566
  10. Aneja K. A rare case of OEIS complex - newer approach to diagnosis of exstrophy bladder by color doppler and its differentiation from simple omphalocele. Indian J Radiol Imaging 2017;27(4):436–440. DOI: 10.4103/ijri.IJRI_443_16
  11. Ples L, Chicea R, Poenaru MO, et al. Can anorectal atresia be diagnosed in the first trimester of pregnancy? A systematic literature review. Medicina (Kaunas) 2020;56(11): DOI: 10.3390/medicina56110583
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.