Abstract
Antenatal ultrasonography has clearly defined many fetal abnormalities, permitting referral and interdisciplinary consultation prior to delivery. We sought to determine its impact at a tertiary perinatal center. During the past 6 years(1978-83), >15,000 examinations were completed by a single observer (MJ). Indications included genetic amniocentesis(3,414 cases), size-date discrepancy, and suspicion of fetal malformations (based on history or alpha fetoprotein screening). Although the number of genetic studies increased from 268 in 1978 to>700 in 1982/83 the main indication, maternal age >35 yrs(68%), and number of chromosome abnormalities (2.3±0.6%), remained constant. Major anatomic malformations were identified in 139 fetuses, 0.9% of all studies, including the CNS (39%), genito-urinary (19%) and gastrointestinal (13%) systems. 56 were diagnosed before 21 wks of which 38 pregnancies were terminated. Better planning of delivery and operative care was possible, particularly with gastrointestinal lesions and abdominal wall defects. The natural history of many of the lesions was unknown. The ultrasound diagnosis was confirmed after delivery in all but 5 cases. To date, only 1 lethal malformation (infantile polycystic kidneys) was missed. We conclude ultrasonographic technology is currently in advance of knowledge of the natural history of many lesions diagnosed early. This presents a dilemma for both staff and patients alike. To fully utilize available resources a multidisciplinary fetal diagnostic and therapeutic team should be established at tertiary perinatal centers.
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Fanaroff, A., Jassani, M., Gauderer, M. et al. ANTENATAL ULTRASOUND-PERINATAL IMPLICATIONS. Pediatr Res 18 (Suppl 4), 182 (1984). https://doi.org/10.1203/00006450-198404001-00536
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DOI: https://doi.org/10.1203/00006450-198404001-00536