Liveborn case of limb-body wall complex with identification of the extraembryonic coelomic cavity on third trimester ultrasound

Introduction: Limb-body wall complex (LBWC), also known as body stalk anomaly, is a rare and lethal congenital condition affecting multiple organ systems, including the abdominal and thoracic walls, limbs, craniofacial structures, and spine. It is characterized by visceral attachment to the placenta with a short or absent umbilical cord, along with spinal deformities. The exact pathogenesis of LBWC remains unknown, though several theories have been proposed, including early amnion rupture, primary ectodermal failure of the embryonic disc, and impaired embryonic blood flow. The herniation of abdominal contents into the extraembryonic coelomic cavity, the space between the chorion and the amnion, rather than the amniotic cavity, helps differentiate LBWC from complex omphalocele. Case Report: We present the ultrasound findings of LBWC in a patient at 32 weeks and 5 days who presented with preterm contractions and suspected rupture of membranes. Despite it being unusual to observe the space between the amnion and chorion at this gestational age, prenatal ultrasound clearly revealed significant herniation of intra-abdominal organs into the extraembryonic coelomic cavity. The patient subsequently underwent a liveborn vaginal delivery the following day. Conclusion: Recognition of herniation of abdominal contents into the extraembryonic coelomic cavity can help differentiate LBWC from other anterior abdominal wall defects, even in late gestation. Accurate diagnosis of LBWC in the third trimester can facilitate appropriate patient counseling and perinatal care planning.