Perinatal and Neonatal Outcomes of Patients Who Were Diagnosed with Neural Tube Defect in Midtrimester Fetal Ultrasound Scan and Refused Request for Termination of Pregnancy

Abstract

Objectives. In this study, we aimed to demonstrate the perinatal and neonatal outcomes of patients who were diagnosed with neural tube defect (NTD) in the midtrimester fetal ultrasound scan and refused the request for termination of pregnancy. Material and Methods. The records of 69 patients, for whom NTD was detected in the midtrimester fetal ultrasound scan and who preferred the continuation of the pregnancy after comprehensive counselling about the possible prognosis and treatment options during the period between January 2011 and February 2016, were reviewed retrospectively. Results. Of these patients, 66.7% were 25–35 years old; 95.7% were multiparous; and 1.4% had a history of a fetus having NTD in previous pregnancies. There were 7 (10.1%) neonatal deaths in these patients. Meningomyelocele closure procedure was the most performed surgery in the postnatal period (92%). Of these patients, 30.7% had paraplegia; 51.6% had neurogenic bladder; and 6.4% had infections due to surgery. Conclusion. The results of this study demonstrated perinatal and neonatal outcomes of fetuses with NTD who were not terminated by the preference of the family in midtrimester. The experience of our centre would be beneficial as a tool for nondirective counselling of these patients when considering the antenatal/postnatal care options and postnatal prognosis.

Evaluation of Newborns with Open Neural Tube Defect Retrospectively

“…nın yaptığı ve 69 NTD' li yenidoğanın alınıp yedi vakanın eksitus olduğu ve 62 vakanın incelendiği çalışmada; operasyon zamanının mediyan olarak bir (1-21) gün olduğu, VPŞ gereksiniminin %33,8 (21/62 hasta), paraplejinin %30,7 (19/62 hasta), nörojenik mesanenin %51,6 (32/62 hasta) ve operasyon nedeniyle enfeksiyon oranının %6,4 (4/62 hasta) olduğu bildirilmiştir. 16 Çalışmamızda; BOS sızıntısının %34,2 (27/79 hasta), menenjitin %46,8 (37 hasta) kanıt-lanmış sepsisin %20,3 (16 hasta), cerrahi yara yeri enfeksiyonunun %6,3 (5 hasta), alt ekstremitede kuvvet kaybının %60,8 (48 hasta), nörojenik mesanenin %51,9 (41 hasta), pes ekinovarusun %27,8 (22 hasta) ve İYE'nin %20,3 (16 hasta) oranında gö-rüldüğü saptanmıştır.…”

Mortality by mode of delivery among infants with spina bifida in Texas

“…Three theoretical mechanisms have been proposed for this hypothesis: (a) compression during a vaginal delivery may result in trauma to the lesion (Heffez, Aryanpur, Hutchins, & Freeman, ; Luthy et al, ; Stark & Drummond, ), (b) exposure to amniotic fluid or the bacterial flora of the vagina during a vaginal delivery might increase neural damage and increase the likelihood of infection (Heffez et al, ; Sakala, Erhard, & White, ), and (c) a planned cesarean may improve coordination of postdelivery care (e.g., reducing time to surgery) (Luthy et al, ; Pinto et al, ; Radcliff et al, ). However, only a few studies have evaluated the association between cesarean delivery and mortality, and results have been mixed, with risk estimates ranging from 0.52 to 4.52 (Bensen, Dillard, & Burton, ; Bol et al, ; Greene et al, ; Melekoglu, Eraslan, Celik, & Simsek, ; Merrill et al, ).…”