Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Define an omphalocoele 2. Discuss the steps to take after an omphalocoele is diagnosed on sonogram
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Omphalocele, or exomphalos, is the protrusion of internal organs, which may include intestines, liver (when present=giant omphalocele) and other abdominal organs, through the ventral wall of the fetus or infant and covered by a membrane consisting of peritoneum, Wharton’s jelly, and amnion
Results from failure of involved organs to return to abdominal cavity from the gut tube during 6-10 weeks of development
Estimated to occur in approximately 1/5400 births
Chromosomal abnormalities may be as high as 50%
Increased risk of chromosomal abnormalities related to presence of other anatomic anomalies or increased nuchal translucency
Trisomy 18 is the most commonly identified aneuploidy
Often associated with cardiac and/or neural tube defects
Image credit: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
Cause of omphalocele unknown in most cases. Associations demonstrated with maternal history of:
Alcohol use in pregnancy
Prenatal Screening and detection is available:
Maternal Serum AFP (MSAFP) is elevated
Amniotic fluid AFP (AFAFP) is elevated
Can be detected on prenatal ultrasound
If an omphalocele is identified on sonography, consider:
Fetal chromosomal analysis including microarray as recommended by ACOG
Fetal echocardiogram referral
Genetic counseling to help identify potential causes, recurrence risk and management plan
Note: physiologic omphalocele may be noted in the first trimester but resolves by 12 weeks gestation
Liver should never be seen outside the fetal abdomen and this finding allows the diagnosis at any time in gestation
Refer to pediatric surgical specialist to discuss possible surgical correction options, outcomes and long term implications
Develop labor and delivery plan for those who will continue the pregnancy given high risk nature of pregnancy, and coordinate with NICU and pediatric team as needed
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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