Evaluation of First-Trimester Physiological Midgut Herniation Using Three-Dimensional Ultrasound
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INTRODUCTION: The aim of this study was to investigate the development of midgut herniation in vivo using three-dimensional (3D) ultrasonographic volume and distance measurements and to create reference data for physiological midgut herniation in ongoing pregnancies in a tertiary hospital population. MATERIALS AND METHODS: The transvaginal 3D ultrasound volumes of 112 women, seen weekly during the first trimester of pregnancy, were obtained and subsequently analysed in a virtual reality environment. The width of the umbilical cord insertion, the maximum diameter of the umbilical cord, and the volume of midgut herniation were measured from 6 until 13 weeks gestational age (GA). RESULTS: All parameters had a positive relation with GA, crown-rump length, and abdominal circumference. In approximately 1 of 10 volumes no midgut herniation could be observed at 9 and 10 weeks GA. In 5.0% of the fetuses the presence of midgut herniation could still be visualised at 12 weeks GA. CONCLUSION: Reference charts for several dimensions of physiological midgut herniation were created. In the future, our data might be used as a reference in the first trimester for comparison in case of a suspected pathological omphalocele.
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Mid-gut herniation is associated with gestational age, presenting in approximately 60% of fetuses before 10 weeks and in only 5% at 12 weeks.
“Additionally, mid-gut herniation is associated with gestational age, presenting in approximately 60% of fetuses before 10 weeks and in only 5% at 12 weeks, a fact that should be considered when evaluating the abdominal wall [50].”
From First-Trimester Ultrasound: A Comparative Review of Guidelines (2026) · cites this paper as [50]
Cites
The 11–13-week scan: diagnosis and outcome of holoprosencephaly, exomphalos and megacystis
Kagan, K. O., Staboulidou, I., Syngelaki, A., Cruz, J., & Nicolaides, K. H. (2010) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.7646 · Cited by 108 · see citing works
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Turner syndrome-omphalocele association: incidence, karyotype, phenotype and fetal outcome
Bedei, I., Gloning, K., Joyeux, L., Meyer‐Wittkopf, M., Willner, D., Krapp, M., Scharf, A., Degenhardt, J., Heling, K., Kozlowski, P., et al. (2023) · Prenatal Diagnosis · doi:10.1002/pd.6302 · Cited by 8 · see citing works
First-Trimester Ultrasound: A Comparative Review of Guidelines
Boureka, E., Tsakiridis, I., Michos, G., Liberis, A., Giouleka, S., Mamopoulos, A., Kalogiannidis, I., & Dagklis, T. (2026) · Diagnostics · doi:10.3390/diagnostics16111695
- Authors
- Bogers, H., Baken, L., Cohen-Overbeek, T. E., Koning, A. H. J., Willemsen, S. P., van der Spek, P. J., Exalto, N., & Steegers, E. A. P.
- Affiliations
- Erasmus MC (NL)
- ORCID
- Venue
- Fetal Diagnosis and Therapy
- Publisher
- S. Karger AG
- Published
- 2018-08-15
- Volume
- 45
- Issue
- 5
- Pages
- 332-338
- ISSN
- 1015-3837 (ISSN-L)
- 1421-9964
- PMC
- PMC6549455
- OpenAlex
- W2885498160
- Cited by
- 17
- References
- 1
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 2
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Fetal Diagnosis and Therapy (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (acceptedVersion, cc-by-nc-nd)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Funders
- Erasmus+
- Topics
- Health Sciences › Medicine › Surgery › Congenital Anomalies and Fetal Surgery
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Surgery › Intestinal Malrotation and Obstruction Disorders
- Keywords
- omphalocele, first trimester, 3D ultrasound, reference values, umbilical cord insertion, umbilical cord diameter, fetal growth, transvaginal ultrasound
- MeSH terms
- Adult, Female, Humans, Organ Size, Pregnancy, Pregnancy Trimester, First, Umbilical Cord, Ultrasonography, Prenatal, Imaging, Three-Dimensional, Hernia, Abdominal
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