Universität zu Köln

Domroese, Christian M., Bremer, Sandra, Buczek, Caroline, Geipel, Annegret, Berg, Christoph, Hellmund, Astrid, Gembruch, Ulrich ORCID: 0000-0001-8284-4669 and Willruth, Arne (2018). Termination of pregnancy following prenatally diagnosed central nervous system malformations. Arch. Gynecol. Obstet., 298 (5). S. 903 - 911. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-0711

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Abstract

PurposeTo 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 methodsCases of singleton pregnancies above 18+0weeks 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.ResultsDuring 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+0weeks 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.ConclusionGeneral implementation of ultrasound screening in maternity care can significantly reduce the number of late TOPs in Germany.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Domroese, Christian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bremer, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Buczek, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Geipel, Annegret UNSPECIFIED UNSPECIFIED UNSPECIFIED Berg, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmund, Astrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Gembruch, Ulrich UNSPECIFIED orcid.org/0000-0001-8284-4669 UNSPECIFIED Willruth, Arne UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-168570
DOI:	10.1007/s00404-018-4900-8
Journal or Publication Title:	Arch. Gynecol. Obstet.
Volume:	298
Number:	5
Page Range:	S. 903 - 911
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-0711
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULTRASOUND EXAMINATION; DANDY-WALKER; FETAL-BRAIN; ANOMALIES; PERFORMANCE; GUIDELINES; GESTATION Multiple languages Obstetrics & Gynecology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16857