Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review

Objective: To compare the maternal morbidities between early (< 22 weeks gestation) and late (≥ 22 weeks gestation) termination of pregnancy (TOP) among pregnant mothers with prenatal diagnosis of lethal fetal anomalies. Methods: This was a retrospective study reviewing all patients diagnosed...

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Main Authors:	S.L., Yong, Abdulwahab, Dalia F, Ismail, Hamizah, Ismail, Rozihan, Awang, Mokhtar, Abdullah, Suhaiza
Format:	Conference or Workshop Item
Language:	English English
Published:	2012
Subjects:	RG Gynecology and obstetrics
Online Access:	http://irep.iium.edu.my/31339/ http://irep.iium.edu.my/31339/2/Dr_Dalia_Abdul_Wahab_.pdf http://irep.iium.edu.my/31339/5/Early_and_Late_TOP_for_Letal_Fetal_Anomalies_Poster_DaliaF.pdf

id	iium-31339
recordtype	eprints
spelling	iium-313392013-09-04T03:15:21Z http://irep.iium.edu.my/31339/ Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review S.L., Yong Abdulwahab, Dalia F Ismail, Hamizah Ismail, Rozihan Awang, Mokhtar Abdullah, Suhaiza RG Gynecology and obstetrics Objective: To compare the maternal morbidities between early (< 22 weeks gestation) and late (≥ 22 weeks gestation) termination of pregnancy (TOP) among pregnant mothers with prenatal diagnosis of lethal fetal anomalies. Methods: This was a retrospective study reviewing all patients diagnosed prenatally to carry lethal fetal anomalies in Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia during the year of 2011. Data was traced from patients’ medical record in hospital record office. These patients were divided into 2 groups, i.e. early and late TOP groups. The maternal morbidities and outcome of these 2 groups of patients were compared. Data was analyzed by using SPSS version 17.0. Results: There were 25 patients diagnosed (via ultrasound with or without genetic study) to have lethal fetal anomalies, included fetuses with multiple structural abnormalities (40.0%), anencephaly or severe encephalocele (32.0%), non-immune hydrops fetalis (16.0%) and syndromic fetuses (12.0%) i.e. Pentalogy of Cantrell and Edward’s syndrome. Seven (28.0%) and 18 (72.0%) patients had early and late TOP respectively. All patients with early TOP aborted vaginally. Among those with late TOP, 5 (27.8%) patients had complicated delivery, included 3 (16.7%) with assisted breech delivery and 2 (11.1%) with abdominal delivery. The abdominal deliveries were for transverse lie in labour and emergency hysterotomy for failed induction complicated by hysterectomy for ruptured uterus noted intraoperatively. Patients with late TOP were more prevalent to morbidities compared to early TOP arm, i.e. frequent hospital admissions (33.3% vs 14.3%), abnormal lie in labour (22.2% vs 0.0%), symptomatic polyhydramnios requiring amnioreduction (22.2% vs 0.0%), post-partum haemorrhage (16.7% vs 0.0%), blood transfusion (11.1% vs 0.0%) and uterine rupture (5.6% vs 0.0%). Mean duration of hospital stay was slightly longer in the late TOP group (6.9±4.1 days) than the early TOP group (5.7±2.8 days). One patient with late TOP developed impending eclampsia requiring IV MgSO4 infusion. However, there was higher prevalence of retained placenta in the group of early TOP (28.6%) compared to the group of late TOP (5.6%). One patient with early TOP developed endometritis following manual removal of retained placenta. Conclusion: Patients with late TOP seem to have more morbidities compared to patients with early TOP though the sample size is too small to yield statistically significant result. It may suggest that early prenatal diagnosis and TOP are essential to minimize the maternal morbidities and improve the outcome. More data need to be recruited to prove this conclusion. 2012 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/31339/2/Dr_Dalia_Abdul_Wahab_.pdf application/pdf en http://irep.iium.edu.my/31339/5/Early_and_Late_TOP_for_Letal_Fetal_Anomalies_Poster_DaliaF.pdf S.L., Yong and Abdulwahab, Dalia F and Ismail, Hamizah and Ismail, Rozihan and Awang, Mokhtar and Abdullah, Suhaiza (2012) Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review. In: 10th RCOG International Scientific Congress , 5-8th June 2012, Kuching, Sarawak.
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics S.L., Yong Abdulwahab, Dalia F Ismail, Hamizah Ismail, Rozihan Awang, Mokhtar Abdullah, Suhaiza Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
description	Objective: To compare the maternal morbidities between early (< 22 weeks gestation) and late (≥ 22 weeks gestation) termination of pregnancy (TOP) among pregnant mothers with prenatal diagnosis of lethal fetal anomalies. Methods: This was a retrospective study reviewing all patients diagnosed prenatally to carry lethal fetal anomalies in Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia during the year of 2011. Data was traced from patients’ medical record in hospital record office. These patients were divided into 2 groups, i.e. early and late TOP groups. The maternal morbidities and outcome of these 2 groups of patients were compared. Data was analyzed by using SPSS version 17.0. Results: There were 25 patients diagnosed (via ultrasound with or without genetic study) to have lethal fetal anomalies, included fetuses with multiple structural abnormalities (40.0%), anencephaly or severe encephalocele (32.0%), non-immune hydrops fetalis (16.0%) and syndromic fetuses (12.0%) i.e. Pentalogy of Cantrell and Edward’s syndrome. Seven (28.0%) and 18 (72.0%) patients had early and late TOP respectively. All patients with early TOP aborted vaginally. Among those with late TOP, 5 (27.8%) patients had complicated delivery, included 3 (16.7%) with assisted breech delivery and 2 (11.1%) with abdominal delivery. The abdominal deliveries were for transverse lie in labour and emergency hysterotomy for failed induction complicated by hysterectomy for ruptured uterus noted intraoperatively. Patients with late TOP were more prevalent to morbidities compared to early TOP arm, i.e. frequent hospital admissions (33.3% vs 14.3%), abnormal lie in labour (22.2% vs 0.0%), symptomatic polyhydramnios requiring amnioreduction (22.2% vs 0.0%), post-partum haemorrhage (16.7% vs 0.0%), blood transfusion (11.1% vs 0.0%) and uterine rupture (5.6% vs 0.0%). Mean duration of hospital stay was slightly longer in the late TOP group (6.9±4.1 days) than the early TOP group (5.7±2.8 days). One patient with late TOP developed impending eclampsia requiring IV MgSO4 infusion. However, there was higher prevalence of retained placenta in the group of early TOP (28.6%) compared to the group of late TOP (5.6%). One patient with early TOP developed endometritis following manual removal of retained placenta. Conclusion: Patients with late TOP seem to have more morbidities compared to patients with early TOP though the sample size is too small to yield statistically significant result. It may suggest that early prenatal diagnosis and TOP are essential to minimize the maternal morbidities and improve the outcome. More data need to be recruited to prove this conclusion.
format	Conference or Workshop Item
author	S.L., Yong Abdulwahab, Dalia F Ismail, Hamizah Ismail, Rozihan Awang, Mokhtar Abdullah, Suhaiza
author_facet	S.L., Yong Abdulwahab, Dalia F Ismail, Hamizah Ismail, Rozihan Awang, Mokhtar Abdullah, Suhaiza
author_sort	S.L., Yong
title	Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
title_short	Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
title_full	Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
title_fullStr	Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
title_full_unstemmed	Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
title_sort	material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review
publishDate	2012
url	http://irep.iium.edu.my/31339/ http://irep.iium.edu.my/31339/2/Dr_Dalia_Abdul_Wahab_.pdf http://irep.iium.edu.my/31339/5/Early_and_Late_TOP_for_Letal_Fetal_Anomalies_Poster_DaliaF.pdf
first_indexed	2023-09-18T20:45:34Z
last_indexed	2023-09-18T20:45:34Z
_version_	1777409651238764544

Material outcome of early versus late termination of pregnancy among pregnant mothers with prenatal diagnosis of lethal fetal anomalies: a retrospective review

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