Ultrasound diagnosis of fetal anomalies: an analysis of perinatal management of 318 consecutive pregnancies in a multidisciplinary setting

Abstract

The multidisciplinary perinatal team worked well in making decisions about obstetric management. In 30% of the cases, this concerned end-of-life decisions. However, for the majority of cases, the perinatal team did not plan neonatal management before birth and thereby did not attune obstetric and neonatal management to each other. This probably reflects the different attitudes towards end-of-life decisions between obstetricians and neonatologists. However, to ensure a consistent perinatal management, a multidisciplinary perinatal team has to make prenatal decisions about both obstetric and neonatal management.

Outcome of pregnancies complicated by oligohydramnios or anhydramnios of renal origin

“…It is characterised by poorly differentiated nephrons, increased stroma and, occasionally, cysts, and metaplastic tissue. Kidneys with abnormal size or structure on prenatal ultrasound, with exclusion of polycystic or hydronephrotic kidneys, are called dysplastic, and therefore include a large variety of disorders—from renal agenesis to massive cystic kidneys (Bijma et al , 2004; Winyard and Chitty, 2008).…”

“…Prenatally, it presents as large hyperechogenic kidneys. The incidence is one in 40 000 live births (Bijma et al , 2004).…”

Paediatrics‐based fetal care: unanswered ethical questions

“…Unfortunately, little data on counseling patterns are available to inform policy. Prenatal health care providers from different disciplines may have different professional priorities (or loyalties), although individual moral views and priorities will certainly vary (1)(2)(3)(4)(9)(10)(11). A few studies have demonstrated differences in attitudes regarding prenatal and perinatal care between paediatric and obstetric specialists specifically (3,10,11).…”

Lack of institutional pathways for referral: results of a survey among pediatric surgeons on prenatal consultation for congenital anomalies

“…Ultrasound screening programs detect a number of fetal abnormalities, leading to a wide range of decisions to be made by prospective parents, while at the same time ensuring optimal prenatal and postnatal treatment to the affected child …”