A retrospective review of 25 cases of lethal fetal anomalies
Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English English |
Published: |
IIUM Press
2016
|
Subjects: | |
Online Access: | http://irep.iium.edu.my/50920/ http://irep.iium.edu.my/50920/ http://irep.iium.edu.my/50920/1/6A.retrospective_review.pdf http://irep.iium.edu.my/50920/4/50920_A%20retrospective%20review%20of%2025%20cases%20of%20lethal%20fetal%20anomalies_Scopus.pdf |
id |
iium-50920 |
---|---|
recordtype |
eprints |
spelling |
iium-509202017-09-27T05:54:21Z http://irep.iium.edu.my/50920/ A retrospective review of 25 cases of lethal fetal anomalies Abdulwahab, Dalia F Ismail, Hamizah Nusee, Zalina S.L., Yong Awang, Mokhtar RG Gynecology and obstetrics Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice. IIUM Press 2016-06-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/50920/1/6A.retrospective_review.pdf application/pdf en http://irep.iium.edu.my/50920/4/50920_A%20retrospective%20review%20of%2025%20cases%20of%20lethal%20fetal%20anomalies_Scopus.pdf Abdulwahab, Dalia F and Ismail, Hamizah and Nusee, Zalina and S.L., Yong and Awang, Mokhtar (2016) A retrospective review of 25 cases of lethal fetal anomalies. International Medical Journal Malaysia, 15 (1). pp. 19-23. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/Volume%2015%20No%201/original_article/Vol15No1JUNE-2016-019-023.pdf |
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 Abdulwahab, Dalia F Ismail, Hamizah Nusee, Zalina S.L., Yong Awang, Mokhtar A retrospective review of 25 cases of lethal fetal anomalies |
description |
Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and
maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25
women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on
patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were
found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound
and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9
years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and
mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%)
women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight
(32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or
aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal
delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to
emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus.
Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained
placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital
stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various
maternal morbidities, in this case series , which could have been prevented if they were diagnosed and
terminated at early trimester. A new direction is needed in our local practice. |
format |
Article |
author |
Abdulwahab, Dalia F Ismail, Hamizah Nusee, Zalina S.L., Yong Awang, Mokhtar |
author_facet |
Abdulwahab, Dalia F Ismail, Hamizah Nusee, Zalina S.L., Yong Awang, Mokhtar |
author_sort |
Abdulwahab, Dalia F |
title |
A retrospective review of 25 cases of lethal fetal
anomalies |
title_short |
A retrospective review of 25 cases of lethal fetal
anomalies |
title_full |
A retrospective review of 25 cases of lethal fetal
anomalies |
title_fullStr |
A retrospective review of 25 cases of lethal fetal
anomalies |
title_full_unstemmed |
A retrospective review of 25 cases of lethal fetal
anomalies |
title_sort |
retrospective review of 25 cases of lethal fetal
anomalies |
publisher |
IIUM Press |
publishDate |
2016 |
url |
http://irep.iium.edu.my/50920/ http://irep.iium.edu.my/50920/ http://irep.iium.edu.my/50920/1/6A.retrospective_review.pdf http://irep.iium.edu.my/50920/4/50920_A%20retrospective%20review%20of%2025%20cases%20of%20lethal%20fetal%20anomalies_Scopus.pdf |
first_indexed |
2023-09-18T21:12:03Z |
last_indexed |
2023-09-18T21:12:03Z |
_version_ |
1777411318316269568 |