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...

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Main Authors: Abdulwahab, Dalia F, Ismail, Hamizah, Nusee, Zalina, S.L., Yong, Awang, Mokhtar
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
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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
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