Maternal outcome of prenatally diagnosed lethal fetal anomalies: a year review
Objectives: To determine maternal morbidities in relation to prenatal diagnosis of lethal fetal anomalies and termination of pregnancy (TOP). Materials: Twenty five patients with prenatal diagnosis of lethal fetal anomalies in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. Methods: This wa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English English |
| Published: |
Elsevier BV
2012
|
| Subjects: | |
| Online Access: | http://irep.iium.edu.my/32311/ http://irep.iium.edu.my/32311/1/FIGO_publicatio.pdf http://irep.iium.edu.my/32311/4/ScienceDirect_-_Search_Results__AUTHORS%28D_Abdulwahab%29.htm |
| Summary: | Objectives: To determine maternal morbidities in relation to
prenatal diagnosis of lethal fetal anomalies and termination of
pregnancy (TOP).
Materials: Twenty five patients with prenatal diagnosis of lethal
fetal anomalies in Hospital Tengku Ampuan Afzan, Kuantan,
Malaysia.
Methods: This was a retrospective review in Hospital Tengku
Ampuan Afzan, Kuantan, Malaysia in the year of 2011. All patients
diagnosed prenatally to carry lethal fetal anomalies was reviewed.
Data regarding maternal morbidities and outcome was collected
from patients’ case note in the hospital record office. Analysis was
done by using SPSS version 17.0.
Results: Twenty five pregnant patients were diagnosed with lethal
fetal anomalies via ultrasound with or without genetic study. The
patients’ mean age was 29.9±6.3 years old. The mean gestational
age at diagnosis of lethal fetal anomalies and at TOP or delivery
were 26.5±7.4 and 28.7±7.8 weeks respectively. The lethal fetal
anomalies included fetuses with multiple structural abnormalities
(40%), anencephaly or severe encephalocele (32%), non-immune
hydrops fetalis (16%) and syndromic fetuses (12%) i.e. Pentalogy
of Cantrell and Edward’s syndrome. Seven (28%) patients had early
counseling and TOP at the gestation of <22 weeks. Beyond 22 weeks
gestation, 8 (32%) patients had TOP and 10 (40%) patients had
spontaneous delivery. Twenty (80%) patients delivered or aborted
vaginally, 3 (12%) patients with assisted breech delivery, and 2 (8%)
patients with abdominal delivery.
The abdominal deliveries were for transverse lie in labour
and emergency hysterotomy for failed induction complicated by
hysterectomy due to intraoperative finding of ruptured uterus.
Overall, the associated adverse events included abnormal lie
during delivery (16%), symptomatic polyhydramnios requiring
amnioreduction (16%), post-partum haemorrhage (12%), retained
placenta (12%), blood transfusion (8%), uterine rupture (4%)
and endometritis (4%). Mean duration of hospital stay was
6.6±3.7 days.
Conclusions: Prenatal diagnosis and TOP at an early gestation may
reduce maternal morbidities and improve the outcome |
|---|