A retrospective review of 25 cases of lethal fetal anomalies

Abdulwahab, Dalia F and Ismail, Hamizah and Nusee, Zalina and S.L., Yong and Awang, Mokhtar (2016) A retrospective review of 25 cases of lethal fetal anomalies. International Medical Journal Malaysia, 15 (1). pp. 19-23. ISSN 1823-4631

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Abstract

Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice.

Item Type:	Article (Journal)
Additional Information:	6094/50920
Uncontrolled Keywords:	Lethal foetal anomalies, termination of pregnancy, anomaly scan, prenatal screening/ diagnosis
Subjects:	R Medicine > RG Gynecology and obstetrics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Obstetric & Gynecology
Depositing User:	DR DALIA ABDULWAHAB
Date Deposited:	08 Jun 2016 11:01
Last Modified:	27 Sep 2017 13:54
URI:	http://irep.iium.edu.my/id/eprint/50920

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