Consequences of prenatal ultrasound diagnosis, A preliminary report on neonates with congenital malformations

Skari, Hans; Björnland, Kristin; Bjørnstad-Østensen, Anniken; Haugen, Guttorm; Emblem, Ragnhild

doi:10.1034/j.1600-0412.1998.770610.x

Cited by 28 publications

(21 citation statements)

References 36 publications

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“…Gastroschisis and cardiac abnormalities are examples of such conditions (16–18). However, Skari et al (19) did not find any improvement in neonatal outcome in a group where congenital anomalies were known before delivery.…”

Section: Discussionmentioning

confidence: 93%

Routine ultrasound screening and detection of congenital anomalies outside a university setting

Nakling¹,

Backe

2005

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 93%

Routine ultrasound screening and detection of congenital anomalies outside a university setting

Nakling¹,

Backe

2005

Acta Obstet Gynecol Scand

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“…In addition, early prenatal ultrasound diagnosis of brain malformations or early intrauterine infections, and the opportunity for early termination of pregnancy, may have reduced the frequency of these causal pathways to CP. However, little evidence for this possibility currently exists . Systematic immunization for rubella, which was introduced in 1989, and a greater uptake of advice to pregnant mothers against preparing or eating undercooked meat, avoiding unpasteurized soft cheeses, and handling cats, may have reduced the likelihood of CP due to rubella, toxoplasmosis, or listeria infections.…”

Section: Discussionmentioning

confidence: 99%

Temporal trends in cerebral palsy by impairment severity and birth gestation

Reid

Meehan

McIntyre

et al. 2016

Develop Med Child Neuro

114

109

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AIM Our aim was to build on previous research indicating that rates of cerebral palsy (CP) in the Australian state of Victoria are declining, and examine whether severity of impairments is also decreasing.METHOD Data on individuals with CP were extracted from the Victorian Cerebral PalsyRegister for birth years 1983 to 2009. The yearly rates of dichotomized categories for gross motor function, motor laterality, intellectual impairment, and epilepsy per 1000 neonatal survivors and proportions in the CP cohort were tabulated and plotted by birth gestation. Linear regression modelling was used to fit prediction curves; likelihood ratio tests were used to test for differences in trends between impairment severity groups.RESULTS Since the mid-1990s, CP rates declined in neonatal survivors of birth at all gestations. Our data suggest that the decreasing CP rates were associated with relatively greater decreases in the rates of Gross Motor Function Classification System levels III to V, bilateral CP, epilepsy, and intellectual impairment (all p<0.005). Some variation was seen between birth gestation groups.

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“…Measures to prevent kernicterus, including effective screening for rhesus incompatibility, anti‐D vaccination, and phototherapy for hyperbilirubinaemia, 17 as well as immunization to prevent rubella infection, 18 would only have had the potential to prevent a few cases, because these causes of CP are relatively rare. Routine ultrasound has increased our capacity to detect fetal brain malformations at a time when offering termination of pregnancy is still an option, but there is no evidence to suggest a difference in long‐term outcomes 19 . Inherited or acquired thrombophilia in the mother or infant, placental thrombosis, infection, surgery, and the use of intravascular catheters are all factors that may contribute to the vulnerability of the fetus or infant to stroke, 20 but there is little in the existing literature about the effect of these factors, or of treatments such as anticoagulant therapy, on long‐term outcomes for the infant 21 .…”

mentioning

confidence: 99%

Rates of cerebral palsy in Victoria, Australia, 1970 to 2004: has there been a change?

Reid

Carlin

Reddihough

2011

Developmental Medicine &Amp; Child Neurology

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VCPR Victorian Cerebral Palsy RegisterAIM The aim of this study was to assess overall and gestational age-specific trends in the rate of cerebral palsy (CP) in Victoria, Australia, and to compare these findings with other population data.METHOD Individuals born in Victoria from 1970 to 2004 with non-postneonatally acquired CP were identified from a population register; 3491 were included in the study (1963 males, 1528 females). After a literature review, comparison data were extracted from publications using previously devised inclusion criteria. Rates were calculated per 1000 live births for all CP and by gestational age group: these were tabulated and plotted by year of birth.RESULTS Data from nine registries, including the Victorian register, showed an increase in the rates of CP over the 1970s and 1980s, consistently seen in extremely preterm (<28wks) survivors but also in those born at term ( ‡37wks). Since the early 1990s, CP rates either stabilized or decreased, particularly for children born extremely preterm.INTERPRETATION Increases in the rates of CP during the 1970s and 1980s are in part because of the increasing survival of extremely preterm infants that occurred without a concomitant improvement in neurological outcomes. Evidence from population samples now suggests that this trend has been reversed since the mid-to late 1990s.Much information can be gained from monitoring trends in the rates of cerebral palsy (CP), not only for service provision, but also for what can be learnt about aetiology. Through monitoring trends we may uncover previously unknown associations or risk factors, and we can monitor changes over time in the effects of known antecedents or interventions.We have already learnt important lessons about the aetiology of CP through population surveillance. Although it is now more widely accepted that most cases of CP are the result of many interacting factors, previously the belief was that most CP was caused by birth trauma or intrapartum asphyxia. Efforts to reduce the incidence of CP were largely aimed at decreasing complications during labour and delivery. High hopes were held that the advent of continuous fetal heart monitoring during the 1960s and 1970s would reduce the incidence of hypoxic or ischaemic brain injury through the early detection of signs of fetal distress and intervention in the form of emergency Caesarean section. As a result of this approach, emergency Caesarean rates increased dramatically and fetal deaths during labour decreased, but the expected improvement in CP rates did not eventuate. [1][2][3] Further research suggested that only a small proportion of CP in developed countries was the result of preventable intrapartum events. 4 The aetiology of CP began to be seen more in terms of causal pathways frequently originating in the pre-conception or antenatal periods. 5Monitoring population trends in CP is not an easy task and few groups are in a position to make reliable assessments of trends over time. Most monitoring is carried out by geographically define...

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Consequences of prenatal ultrasound diagnosis, A preliminary report on neonates with congenital malformations

Abstract: The sensitivity of prenatal ultrasound in diagnosing the congenital malformations under study in a low risk population was 19% at 17-18th week of gestation and 36% throughout the pregnancy. Prenatal diagnosis altered management of labor, but caused no improvement in neonatal outcome.

Cited by 28 publications

References 36 publications

Routine ultrasound screening and detection of congenital anomalies outside a university setting

Routine ultrasound screening and detection of congenital anomalies outside a university setting

Temporal trends in cerebral palsy by impairment severity and birth gestation

Rates of cerebral palsy in Victoria, Australia, 1970 to 2004: has there been a change?

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