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Published in:

01-11-2018 | Maternal-Fetal Medicine

Termination of pregnancy following prenatally diagnosed central nervous system malformations

Authors: Christian M. Domröse, Sandra Bremer, Caroline Buczek, Annegret Geipel, Christoph Berg, Astrid Hellmund, Ulrich Gembruch, Arne Willruth

Published in: Archives of Gynecology and Obstetrics | Issue 5/2018

Abstract

Purpose

To analyze fetal cerebral malformations with late termination of pregnancy (TOP) and to evaluate the rate of cases that could have been detected earlier using international recommended requirements of sonographic examination of the fetal central nervous system (CNS).

Materials and methods

Cases of singleton pregnancies above 18 + 0 weeks of gestation ending in late TOP due to fetal CNS malformations between 2002 and 2011 were retrospectively reviewed. The cases were divided into isolated and non-isolated cerebral malformations. Prevalence and timing of TOP were assessed relative to the identified malformations.

Results

During this 10-year period, 212 (20.8%) out of 1017 late TOPs were performed in pregnancies with fetal cerebral malformations. 59 cases were excluded because of chromosomal anomalies. 86 (56.2%) of the remaining 153 cases were isolated cerebral malformations while 67 (43.8%) were non-isolated. TOP after viability (≥ 24 + 0 weeks of gestation) was performed in 61.4% (94/153). Substantial morbidity (n = 80; 52.3%) and mental retardation (n = 33, 38.4%) made up the leading prognostic groups. In about 80% of detectable anomalies, diagnosis of CNS malformation could have been made earlier by following international guidelines of fetal CNS examination at second trimester scan.

Conclusion

General implementation of ultrasound screening in maternity care can significantly reduce the number of late TOPs in Germany.

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Title: Termination of pregnancy following prenatally diagnosed central nervous system malformations
Authors: Christian M. Domröse
Sandra Bremer
Caroline Buczek
Annegret Geipel
Christoph Berg
Astrid Hellmund
Ulrich Gembruch
Arne Willruth
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-4900-8

At a glance: The STEP trials

Springer Medicine

Termination of pregnancy following prenatally diagnosed central nervous system malformations

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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