Antenatal counselling for prospective parents whose fetus has a neurological anomaly: part 2, risks of adverse outcome in common anomalies

Abstract

After diagnosis of a fetal neurological anomaly, prospective parents want to know the best and worst‐case scenarios and an estimation of the risk to their infant of having an atypical developmental outcome. The literature on developmental outcomes for fetal neurological anomalies is poor: studies are characterized by retrospective design, small sample size, often no standardized assessment of development, and differing definitions of anomalies. This review provides an aide‐memoir on the risks of adverse neurodevelopmental outcome for ventriculomegaly, cortical anomalies, microcephaly, macrocephaly, agenesis of the corpus callosum, posterior fossa anomalies, and myelomeningocele, to assist healthcare professionals in counselling. The data in this review should be used alongside recommendations on counselling and service design described in part 1 to provide antenatal counselling.

Antenatal counselling families whose fetus has a neurological anomaly: one parent’s reflections

“…I whole-heartedly support the recommendations set out by Hart et al 1,2 and would like to offer these comments.…”

“…We were told that a stillbirth was, in fact, unlikely and that around three quarters of children with isolated ACC had an outcome in the normal range. 1 Furthermore, we were helped to consider what life might look like with a child with additional needs; what impact it might have on our family; and how the child themselves might experience life.…”

Fetal Neurology: From Prenatal Counseling to Postnatal Follow-Up

“…Embryology should always be the starting point for any specialist involved in fetal counseling in order to recognize not only genetic etiologies, but also trimester-specific mechanisms affecting the fetal development [ 7 ]. An injury to the fetal brain may evolve into brain malformations when it occurs in the first trimester or into destructive lesions when it occurs later during gestation [ 7 , 8 ]. Alcohol abuse, malnutrition, vascular insults, and congenital infections can be responsible for several brain malformations when they occur early during gestation (i.e., corpus callosum agenesis in alcohol abuse and polymicrogyria in CMV infections).…”

Antenatal counselling for prospective parents whose fetus has a neurological anomaly: part 1, experiences and recommendations for service design

“…Because not all pregnant individuals identify as women, we use the term ‘prospective parents’ throughout this article, unless the published data refers specifically to females or male partners. Part 2 of our review will discuss the published risks of atypical developmental outcome in a range of common fetal neurological anomalies 6 …”

“…Part 2 of our review will discuss the published risks of atypical developmental outcome in a range of common fetal neurological anomalies. 6…”