Evaluation of Fetal Central Nervous System Anomalies; Perinatology Council Data of a Reference Center

FORBES Pub Date : 2020-01-01 DOI:10.5222/forbes.2020.30602
Meltem Koyuncu Arslan, M. Akar, H. Pala, C. Taner, M. Oncel
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Abstract

INTRODUCTION: Central nervous system (CNS) anomalies are the second most common congenital malformations detected during antenatal period. Rates of prenatal diagnosis are aroung 96% in anencephaly, but drops down to approximately 14 % in migration anomalies.We aimed to determine the frequency and features of CNS anomalies evaluated in the perinatology council of our hospital where high-risk pregnancies were discussed and also to emphasize the importance of antenatal diagnosis. METHODS: Pregnant women, with a CNS anomaly detected in their fetus, who were evaluated between January 2019-December 2019 in the perinatology council of Tepecik Training and Research Hospital were included in the study. Retrospectively, the records of the cases were examined, prenatal, and maternal risk factors at the time of council session, the council decision and the results were recorded. Statistical analyzes were done using SPSS 20.0 program. RESULTS: Data of 1272 pregnant women were evaluated in the study, and 261 cases (20.5%) with CNS anomalies were detected. A total of 129 pregnant women were excluded from the study because follow-up of these patients were not realized in our center or they didn’t give birth yet.. Totally, 132 pregnant women were included in the study. The mean maternal age was 26.99±6.50 (14-42) years, the mean gestational age was 22.63±7.08 (10.4-38.6) weeks. Most common CNS anomalies detected were neural tube defects (n=54; 40%), hydrocephalus/ventriculomegaly (n=36; 27%), migration defects (n=21; 15%) and cerebellar malformations (n=9; 6%). Termination of pregnancy was decided for 29.8% (n=78) of pregnant women, but realized only for 62 pregnancies. Among pregnancies which were decided to be continued due to the fact that gestational week was 22 weeks or more (n=51), had fetuses with neural tube defects (n=25; 50%) and hydrocephalus/ventriculomegaly (n=36; 27%) with poor prognosis. DISCUSSION AND CONCLUSION: As the anomalies with high morbidity and mortality were referred to our hospital after the 22nd gestational week, termination option could not be offered to these pregnancies. High-risk pregnancies should be directed to perinatology centers in the early period so that this option can be presented to the family, appropriate follow-up and treatment of life-compatible ones.
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胎儿中枢神经系统异常的评价参考中心围产期理事会数据
简介:中枢神经系统(CNS)异常是第二最常见的先天性畸形检测在产前期间。无脑畸形的产前诊断率约为96%,但迁移异常的产前诊断率降至约14%。我们的目的是确定在我们医院的围产期委员会中评估的高危妊娠的频率和特征,并强调产前诊断的重要性。方法:纳入2019年1月至2019年12月在Tepecik培训与研究医院围产期委员会评估的胎儿中检测到中枢神经系统异常的孕妇。回顾性地检查了病例的记录,记录了理事会会议、理事会决定和结果时的产前和产妇危险因素。采用SPSS 20.0软件进行统计学分析。结果:本研究共纳入1272例孕妇资料,检出中枢神经系统异常261例(20.5%)。共有129例孕妇因本中心未对其进行随访或尚未分娩而被排除在本研究之外。共有132名孕妇参与了这项研究。产妇平均年龄26.99±6.50(14 ~ 42)岁,平均胎龄22.63±7.08(10.4 ~ 38.6)周。最常见的中枢神经系统异常是神经管缺陷(n=54;40%),脑积水/脑室肿大(n=36;27%),迁移缺陷(n=21;15%)和小脑畸形(n=9;6%). 29.8% (n=78)的孕妇决定终止妊娠,但只有62例孕妇决定终止妊娠。在因孕周超过22周而决定继续妊娠的孕妇中(n=51),有神经管缺陷的胎儿(n=25;50%)和脑积水/脑室肿大(n=36;27%),预后较差。讨论与结论:由于发病率和死亡率较高的畸形是在妊娠22周后转诊到我院的,这些妊娠不能选择终止妊娠。高危妊娠应在早期被引导到围产期中心,以便向家庭提供这一选择,适当的后续治疗和生活相容的治疗。
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FORBES
FORBES BUSINESS, FINANCE-
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