P A Boyd1, F Tondi, N R Hicks, P F Chamberlain. 1. National Perinatal Epidemiology Unit, Institute of Health Sciences, Headington, Oxford OX3 7LF. Patricia.boyd@orh.nhs.uk
Abstract
OBJECTIVE: To study trends in termination of pregnancy for fetal anomaly over 10 years and to assess the contribution of autopsy to the final diagnosis and counselling after termination. DESIGN: Retrospective study with cases from a congenital anomaly register and a defined unselected population. DATA SOURCES: Pregnancies resulting in termination for fetal anomaly identified from the Oxford congenital anomaly register. Details about the prenatal diagnosis and autopsy findings were retrieved from case notes. RESULTS: Of the 57 258 deliveries, 309 (0.5%) were terminated because of prenatally diagnosed abnormality. There were 129/29 086 (0.4%) terminations for fetal anomaly carried out in 1991-5 and 180/28 172 (0.6%) in 1996-2000. The percentage of fetuses that underwent autopsy fell from 84% to 67%. Autopsy was performed in 132 cases identified by ultrasound scan, with no evidence for abnormal karyotype. In 95 (72%) the autopsy confirmed the suspected diagnosis and did not add important further information, two cases were not classified, and in 35 (27%) the autopsy added information that led to a refinement of the risk of recurrence (reduced in 17, increased in 18); in 11 of these 18 cases it was increased to a one in four risk. CONCLUSIONS: Though there has been an increase in the rate of terminations of pregnancy for fetal anomaly, there has been a decline in the autopsy rate. When a prenatal diagnosis was based on the results of a scan only, the addition of information from an autopsy by a specialist paediatric pathologist provided important information that changed the estimated risk of recurrence in 27% of cases and in 8% this was to a higher (one in four) risk.
OBJECTIVE: To study trends in termination of pregnancy for fetal anomaly over 10 years and to assess the contribution of autopsy to the final diagnosis and counselling after termination. DESIGN: Retrospective study with cases from a congenital anomaly register and a defined unselected population. DATA SOURCES: Pregnancies resulting in termination for fetal anomaly identified from the Oxford congenital anomaly register. Details about the prenatal diagnosis and autopsy findings were retrieved from case notes. RESULTS: Of the 57 258 deliveries, 309 (0.5%) were terminated because of prenatally diagnosed abnormality. There were 129/29 086 (0.4%) terminations for fetal anomaly carried out in 1991-5 and 180/28 172 (0.6%) in 1996-2000. The percentage of fetuses that underwent autopsy fell from 84% to 67%. Autopsy was performed in 132 cases identified by ultrasound scan, with no evidence for abnormal karyotype. In 95 (72%) the autopsy confirmed the suspected diagnosis and did not add important further information, two cases were not classified, and in 35 (27%) the autopsy added information that led to a refinement of the risk of recurrence (reduced in 17, increased in 18); in 11 of these 18 cases it was increased to a one in four risk. CONCLUSIONS: Though there has been an increase in the rate of terminations of pregnancy for fetal anomaly, there has been a decline in the autopsy rate. When a prenatal diagnosis was based on the results of a scan only, the addition of information from an autopsy by a specialist paediatric pathologist provided important information that changed the estimated risk of recurrence in 27% of cases and in 8% this was to a higher (one in four) risk.
Authors: A C G Breeze; F A Jessop; A L Whitehead; P A K Set; L Berman; G A Hackett; C C Lees Journal: Virchows Arch Date: 2007-12-18 Impact factor: 4.064
Authors: Ali Gedikbaşı; Ahmet Gül; Kazım Oztarhan; Mustafa Ali Akın; Akif Sargın; Sibel Ozek; Sultan Kavuncuoğlu; Yavuz Ceylan Journal: J Turk Ger Gynecol Assoc Date: 2010-03-01
Authors: Carlos Pérez-Serrano; Álvaro Bartolomé; Núria Bargalló; Carmen Sebastià; Alfons Nadal; Olga Gómez; Laura Oleaga Journal: Insights Imaging Date: 2021-07-22