Congenital central nervous system anomalies: Ten-year single center experience on a challenging issue in perinatal medicine

Abstract

Objective:Our goal was to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing our clinic’s experience.Material and Methods:We evaluated prenatal findings and postnatal outcomes of neonates who had a CNS anomaly diagnosis in our clinic over a ten-year period. A total of 183 cases with various CNS anomalies were included in the study. Birth or termination preferences of mothers were recorded in all cases, and postnatal diagnosis concordance and prognosis after surgical procedures were evaluated in mothers who chose to continue the pregnancy.Results:The mean maternal age was 28.2±5.5 years, mean gravida was 2.2±1.3, and the mean gestational age at diagnosis was 30.5±5.5 weeks. Seventy-five out of 183 (41%) patients chose to terminate their pregnancy. Twenty babies (26.6%) in the termination of pregnancy group had additional anomalies. One hundred eight patients gave birth at our institution. The mean birth weight was 3060±647.5 g, the mean gestational week at delivery was 37.9±1.7 weeks, and mean APGAR score (5th minute) was 8.8±2.3. Four neonates died on the postpartum first day. The postnatal diagnosis of 60 of the 108 (55.5%) patients who gave birth was concordant with the prenatal diagnosis, and 32 of the 108 (29.6%) babies underwent surgical interventions.Conclusion:CNS anomalies have a broad spectrum and variable prognoses. This study highlights the limitations of prenatal diagnoses, and the need for parents to have this information in order to determine the course of their pregnancy and prepare themselves for the postnatal challenging treatment/rehabilitation process.

5‐year experience of a tertiary center in major congenital abnormalities in singleton pregnancies

“…Thus, we may conclude that developing experience of tertiary centers in special group of patients is important for decreasing mortality in further years. Rate of mortality and TOP was also similar in a previously published study, which was conducted in our institution (Aydın et al, ).…”

Metabolic Infrastructure of Pregnant Women with Fetuses Having Nervous System Abnormalities; Metabolomic Analysis

“…Embryogenesis of CNS can be complicated and may result in mild, moderate or severe congenital defects [2,3]. There is a wide spectrum of fetal nervous system abnormalities (NSA) such as anencephaly, craniorachischisis, iniencephaly, encephalocele, spina bifida, microcephaly, hydrocephaly etc., and these anomalies need to be prenatally diagnosed as early as possible [2][3][4][5]. Genetical, epigenetic and teratological factors are the main courses behind NSA and need to be investigated within the framework of antenatal care programs [6][7][8][9][10][11][12].…”

Effects of Randomized Central Nerve System Anomalies on the Expression of Stem/Progenitor Cell Markers in the Different Components of Human Fetus Umbilical Cord

“…Developmental anomalies of the umbilical cord and fetal blood vessels are associated with central nervous system (CNS) anomalies and are the main causes of compromised fetal circulation [1,2]. CNS anomalies are the second most common type of congenital disorders after common cardiac anomalies in development and often result in stillbirths or miscarriages [3,4].…”