The İmportance of prenatal diagnosıs in fetal anomalies

Amaç

To evaluate fetal anomalies subject of pediatric surgery, diagnosed at seconel trimester of pregnancy or later.

Yöntem

Of the 207 fetuses with anomalies from 3891 labor or abortion, 69 fetuses associated with pediatric surgical anomalies between January 2000 and August 2002 were retrospectively evaluated.

Bulgular

Median delivery time was 37 weeks. Of the 69 fetuses, 38 underwent normal vaginal delivery, 17 cesarean section, and 14 medical abortions before 20 weeks' gestation. Forty-seven fetuses were male and 22 were female. Fifty-six fetuses had diagnosis of at least one anomaly prenatally, while the remaining 13 fetuses all associated with gastrointestinal or genital anomaly had diagnosis postnatally. Of the 69 fetuses, 61% had urinary anomaly, 19% gastrointestinal, 9% genital, 7% thoracic anomaly, and 4% had sacrococcigeal teratoma. The median birth weight was 3548gr (range, 1320-3750gr) in viable births, while it was 762gr (range, 467-1330gr) for non-viable fetuses. Prenatal ultrasound had 98% accuracy and 81% sensitivity in diagnosing detectable fetal organ system anomaly.
Thirty-four percent of fetal anomalies were subject of pediatric surgery in our institution. Urinary anomalies cover nearly two-third of pediatric surgical anomalies. Certain prenatal diagnosis of genital anomalies is quite difficult. If gastrointestinal anomalies are not diagnosed prenatally, postnatal management may delay, which may cause unfavorable outcome in neonates. Antenatal diagnosis of fetal anomalies and prompt prenatal and/or early postnatal treatment in selected patients may significantly decrease neonatal morbidity and mortality. Multidisciplinary team effort is essential in the management and follow-up of fetal anomalies.

Anahtar Kelimeler

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