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Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in The Netherlands.

Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in The Netherlands.

Authors :
Fleurke-Rozema JH
Vogel TA
Voskamp BJ
Pajkrt E
van den Berg PP
Beekhuis JR
Bilardo CM
Brouwer OF
de Walle HE
Snijders RJ
Source :
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology [Ultrasound Obstet Gynecol] 2014 May; Vol. 43 (5), pp. 553-6. Date of Electronic Publication: 2014 Feb 10.
Publication Year :
2014

Abstract

Objective: To examine the impact of introduction of the mid-trimester scan on pregnancy outcome in cases of open spina bifida in two regions of The Netherlands.<br />Methods: This was a retrospective cohort study of 190 cases of open spina bifida diagnosed pre- or postnatally, with an estimated date of delivery between 2003 and 2011.<br />Results: With implementation of the mid-trimester scan the percentage of cases of open spina bifida detected before the 24(th) week of pregnancy increased from 43% to 88%. The rise in prenatal detection rate was associated with a significant increase in the number of terminated pregnancies and a decrease in the rate of perinatal loss; the percentage of children born alive did not change significantly. In the subgroup that underwent a scan between 18 and 24 weeks of pregnancy, cranial signs were present in 94.4% of cases.<br />Conclusion: Introduction of the mid-trimester scan has led to an increase in early identification of pregnancies complicated by open spina bifida. Pregnancies previously destined to end in perinatal loss are now terminated whilst pregnancies with a relatively good prognosis are frequently continued; the number of children with open spina bifida who are born alive has not changed significantly. Our study confirms that prenatal diagnosis is usually triggered by visualization of a lemon-shaped skull or a banana-shaped cerebellum.<br /> (Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1469-0705
Volume :
43
Issue :
5
Database :
MEDLINE
Journal :
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
Publication Type :
Academic Journal
Accession number :
23828717
Full Text :
https://doi.org/10.1002/uog.12546