Prenatal counselling and the role of the paediatric surgeon

Benachi, Alexandra; Sarnacki, Sabine

doi:10.1053/j.sempedsurg.2014.09.002

Cited by 18 publications

(11 citation statements)

References 14 publications

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“…Benachi et al reported that when the fetal malformation is diagnosed in the first trimester, consultation with the pediatric surgeon is important [12]. However, some papers reported that better resolution and increased experience with ultrasound scans has increased the detection rate of fetal anomalies but at the expense of higher false-positive rates [13].…”

Section: Discussionmentioning

confidence: 99%

“…However, some papers reported that better resolution and increased experience with ultrasound scans has increased the detection rate of fetal anomalies but at the expense of higher false-positive rates [13]. Hence, repeated consultations should be recommended for precise information regarding changes seen on ultrasound and/or MRI images, especially in cases where a poor prognosis is expected [12].…”

Section: Discussionmentioning

confidence: 99%

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The Prenatal Diagnosis~ What should we do? What can we do?

2021

sjnp

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Purpose: Prenatal diagnostic accuracy has improved; however, the pediatric surgeon’s role remains unclear. This paper aimed to determine the prenatal diagnoses made and the role of pediatric surgeons. Methods: A 6-year retrospective review of 904 pregnancies managed at our institute was conducted. They were classified as a normal pregnancy (NP, n=194), abnormal pregnancy maternal factor (MF, n=449), or abnormal pregnancy fetal factor (FF, n=261). Results: In the FF group, the identified conditions were twin pregnancies (n=75), intrauterine growth restriction (IUGR) (n=49), breech presentation (n=26), arrested development (n=19), hypoamnion (n=42), fetal distress (n=16), hydramnios (n=10), abnormal heart sounds (n=5), meconium staining (n=5), surface anomaly (n=4), calcification (n=2), fetal hydrops (n=2), fetal death (n=2), bowel dilatation (n=2), abdominal mass (n=1) and diaphragmatic hernia (n=1). Case of twin pregnancies, breech presentation, arrested development, IUGR, hypoamnion, abnormal heart sounds, meconium staining and fetal hydrops did not require surgery. Of the 16 cases of fetal distress, 1 had biliary atresia. Of the 10 cases of hydramnios, 1 had meconium peritonitis. Of the 4 with surface anomalies, 3 had gastroschisis. Of the 2 with calcification, 1 had meconium peritonitis. Of the two fetal deaths, 1 had anal atresia suggesting a chromosomal abnormality. Of the 2 cases of bowel dilatation, 1 had bowel atresia. The abnormal mass was caused by adrenal bleeding. These diagnoses were made at an average of 27.4 gestational weeks; however, 2 cases of gastroschisis, suggesting a body stalk anomaly; diaphragmatic hernia; and brain cysts were diagnosed before 20 weeks and were aborted. After delivery, the mortality rate was 0% in neonates treated by pediatric surgeons and neonatologists. Conclusion: Fetal abnormalities are rare; however, early aggressive management with the cooperation of obstetricians and parents is crucial for pediatric surgeons to minimize the effects of anomalies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Prenatal Diagnosis~ What should we do? What can we do?

2021

sjnp

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“…Accurate anatomical characterization of a fetal malformation is required for the pediatric surgeon to provide appropriate counseling to the parents . For most isolated unilateral urinary tract anomalies, the prognosis is favorable, and US is typically sufficient .…”

Section: Imaging Of the Pathologic Urinary Tractmentioning

confidence: 99%

The use of fetal MRI for renal and urogenital tract anomalies

et al. 2019

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Fetal anomalies are detected in approximately 2% of all fetuses and, among these, genitourinary tract abnormalities account for 30% to 50% of all structural anomalies present at birth. Although ultrasound remains the first line diagnostic modality, fetal MRI provides important additional structural and functional information, especially with the development of faster sequences and the use of functional sequences. The added value of MRI-based imaging is three-fold: (a) improvement of diagnostic accuracy by adequate morphological examination, (b) detection of additional anomalies, and (c) in addition, MRI has the potential to provide information regarding renal function. In this review, we describe the role of fetal MRI in the anatomical evaluation of renal and urogenital tract anomalies, and we also touch upon the contribution of functional MRI to the diagnostic workup of these conditions.

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“…The management of abdominal wall defects involves multidisciplinary care from obstetricians, neonatologists and paediatric surgeons . Definitive management requires surgical closure.…”

Section: Introductionmentioning

confidence: 99%

Anterior abdominal wall defects managed at a tertiary maternal‐fetal medicine service in New Zealand: What counselling advice can we offer parents?

Narang

Carlsen

Long³

et al. 2019

Aust NZ J Obst Gynaeco

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Background Anterior abdominal wall defects, including gastroschisis and omphalocoele, are common fetal anomalies. The management remains complicated, and their diagnosis may lead to significant parental distress. Effective parental counselling may impact on parental perceptions of the defect and help guide pregnancy management. Aims Using contemporary data, we aimed to describe clinical outcomes of patients with gastroschisis or omphalocoele in order to provide information for clinicians to assist in parental counselling. Materials and Methods We followed a case‐series of patients with anterior abdominal wall defects referred to our regional Maternal Fetal Medicine services from 2011 to 2016. Outcomes of interest antenatally included details of diagnosis, associated anomalies and outcomes of pregnancy and postnatally included the nature of surgical repair, hospital stay and secondary complications until initial discharge. Results Eighty babies with gastroschisis were referred antenatally, and 72 were liveborn. Forty‐nine babies with omphalocoele were referred antenatally, and 24 were liveborn. One further neonate with omphalocoele was postnatally diagnosed. Seventy‐one neonates with gastroschisis progressed to operation, 30 developed complications post‐surgery, and 68 survived until initial discharge. Twenty‐two neonates with omphalocoele progressed to surgery, only two developed complications, and 21 survived until initial discharge. Eight of the surviving neonates with omphalocoele had associated structural abnormalities. The median hospital stay was 27 and eight days for gastroschisis and omphalocoele, respectively. Conclusion Neonates with gastroschisis can have complex postnatal periods. Omphalocoele is associated with high antenatal mortality, especially in the presence of associated abnormalities; however, surviving neonates may have uneventful postnatal periods.

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Prenatal counselling and the role of the paediatric surgeon

Cited by 18 publications

References 14 publications

The Prenatal Diagnosis~ What should we do? What can we do?

The Prenatal Diagnosis~ What should we do? What can we do?

The use of fetal MRI for renal and urogenital tract anomalies

Anterior abdominal wall defects managed at a tertiary maternal‐fetal medicine service in New Zealand: What counselling advice can we offer parents?

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