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Perinatal approach to the prenatal diagnosed anomalies

Year 2006, Volume: 37 Issue: 4, 113 - 117, 01.05.2006

Abstract

Ultrasonography has became an important component of the preventive perinatal approach to diverse categories of high risk pregnancies and fetal structural anomalies. Prenatal diagnosis provides the opportunity to influence perinatal management favorably by changing the site of delivery for immediate postnatal treatment. In this report, the value of prenatal diagnosis in perinatal approach to congenital lesions is emphasized, and perinatal outcomes. of gastrointestinal anomalies which diagnosed prenatally has been evaluated. During a five months period, 900 second level ultrasons were done by gyneocolgists and 89 fetal anomalies were diagnosed and pediatric surgical consultations were performed in our hospital. Pregnancy was terminated in 13% of cases by advices of scientific etic commite. Mode of delivery, timing of delivery, place of delivery were changed in these patients. During that time, 30 cases with gastrointestinal or related anomalies were interned in pediatric surgery department. 5 cases died pre-operation period, 3 cases died after the operation. The diagnosis and management of complex fetal anomalies requite a team effort. CONCLUSION: Forwarning the obstetrician, concultation to pediatric surgery and alerting the pediatric surgical team for resuscitation, immediate postnatal evaluation, and timely intervention decrease neonatal mortality and increase the chance of survive. Prenatal pediatric surgical consultation may have a significant impact on the perinatal management of the fetus with a surgically correctable congenital anomaly. All these should be combined with clear counseling of the parents.

References

  • Jassani MN, Gauderer MW, Fanaroff AA, Fletcher B, Merkatz İR. A perinatal approac to the diagnosis and management of gastrointestinal malformation. Obstet Gynecol, 1982,59:33-39
  • Tolukain RJ, Robbins JC. Maternal ultrasonography in the antenatal diagnosis of surgically correctable fetal anomalies. J Pediatr Surg. 1980, 15: 373- 377
  • Vanessa A, Barss VA, Benacerraf BR, Frigoletto FDJr. Antenatal sonografic diagnosis of fetal gastrointestinal malformations
  • Pediatrics. 1985, 76: 445-449
  • Quinlan RW, Cruz AC, Martin M
  • Hydramnios: Ultrasound diagnosis and its impact on perinatal management and pregnancy outcome. Am J Obstet Gynecol. 1983, 145: 306-311
  • Crombleholme TM, D'Alton M, Cendron M, Alman B, Goldberg MD, Klauber GT, Cohen A, Heilman C, Lewis M, Harris BH
  • Prenatal diagnosis and the pediatric surgeon : The impact of of prenatal concultation on on perinatal management. J Pediatr Surg. 1996, 31: 156-162
  • Dillon PW, Cilley RE. Newborn surgical emergencies.Gastrointestinal anomalies, abdominal wall defects. Pediatr Clin North Am. 1993, 1289-1314
  • Horger EO 3rd, Pai GS. Ultrasound in the diagnosis of fetal malformations
  • Implications for obstetric management. Am J Obstet Gynecol. 1983, 15: 163- 170
  • Harris BA, Wirtschafter DD, Huddleston JF, et al. In utero vs. Neonatal transportation of high-risk perinates: Acomparison. Obstet Gynecol 1981, 57: 496-499
  • Paidas MJ, Crombleholme TM, Robertson FM. Prenatal diagnosis and management of the fetus with an abdominal wall defect. Semin Perinatol 1994, 18: 196-214
  • Sarda P, Bard H, Teasdale F, Grignon A. The importance of an antenatal ultrasonographic diagnosis of correctable fetal malformations. Am J Obstet Gynecol. 1983, 15: 33-39
  • Harrison, HR, Golbus MS, Filly RA
  • Management of the fetus with a correctable congenital defect. JAMA 1981, 246: 774-779

Prenatal tanılı anomalilerde perinatal yaklaşım

Year 2006, Volume: 37 Issue: 4, 113 - 117, 01.05.2006

Abstract

Ultrasonografi, yüksek riskli gebelerin ve fetal anomalilerin takibinde perinatal önlemlerin alınmasında en önemli komponentlerden biridir. Prenatal tanılama, acil müdahale şansını verilecek şekilde doğum yerinin değişmesi fırsatını sağlar. Bu yazıda, konjenital anomalili yenidoğanlara perinatal yaklaşımda prenatal tanılamanın önemi vurgulanmış ve prenatal tanılanmış gastrointestinal anomalilerde perinatal sonuçlar değerlendirilmiştir. Jinekologlar tarafından hastanemizde beş aylık periodda 900 adet ikinci düzey ultrasonografi yapılmış ve 89'unda yapısal fetal anomali saptanmıştır. Anomali saptanan hemen tüm olguda çocuk cerrahisi konsültasyonu istenmiş olup %13ründe gebelik terminasyonu önerilmiştir. Doğu zamanı, doğum şekli ve doğum yeri bu hastalarda değişmiştir. Aynı dönemde çocuk cerrahisi bölümünde 30 gastrointestinal sistem veya onunla ilişkili anomalili yenidoğan interne edilmiştir. 5 olgu ameliyat öncesi dönemde, 3 olgu ise ameliyat sonrası dönemde kaybedilmiştir.SONUÇ: Sonuç olarak kompleks fetal anomalilerin tanı ve tedavisi bir ekip çalışması gerektirir. Kadın doğum uznmanının deneyimli olması ve çocuk cerrahisine konsülte etmesi, çocuk cerrahlarının resussitasyon için alert olmaları, acil postnatal değerlendirme ve zamanında müdahale postnatal mortaliteyi azaltacak ve yaşam süresini artıracaktır. Tüm bunların aileye açıkça anlatılması işbirliğini ve dolayısıyla başarıyı artıracaktır.

References

  • Jassani MN, Gauderer MW, Fanaroff AA, Fletcher B, Merkatz İR. A perinatal approac to the diagnosis and management of gastrointestinal malformation. Obstet Gynecol, 1982,59:33-39
  • Tolukain RJ, Robbins JC. Maternal ultrasonography in the antenatal diagnosis of surgically correctable fetal anomalies. J Pediatr Surg. 1980, 15: 373- 377
  • Vanessa A, Barss VA, Benacerraf BR, Frigoletto FDJr. Antenatal sonografic diagnosis of fetal gastrointestinal malformations
  • Pediatrics. 1985, 76: 445-449
  • Quinlan RW, Cruz AC, Martin M
  • Hydramnios: Ultrasound diagnosis and its impact on perinatal management and pregnancy outcome. Am J Obstet Gynecol. 1983, 145: 306-311
  • Crombleholme TM, D'Alton M, Cendron M, Alman B, Goldberg MD, Klauber GT, Cohen A, Heilman C, Lewis M, Harris BH
  • Prenatal diagnosis and the pediatric surgeon : The impact of of prenatal concultation on on perinatal management. J Pediatr Surg. 1996, 31: 156-162
  • Dillon PW, Cilley RE. Newborn surgical emergencies.Gastrointestinal anomalies, abdominal wall defects. Pediatr Clin North Am. 1993, 1289-1314
  • Horger EO 3rd, Pai GS. Ultrasound in the diagnosis of fetal malformations
  • Implications for obstetric management. Am J Obstet Gynecol. 1983, 15: 163- 170
  • Harris BA, Wirtschafter DD, Huddleston JF, et al. In utero vs. Neonatal transportation of high-risk perinates: Acomparison. Obstet Gynecol 1981, 57: 496-499
  • Paidas MJ, Crombleholme TM, Robertson FM. Prenatal diagnosis and management of the fetus with an abdominal wall defect. Semin Perinatol 1994, 18: 196-214
  • Sarda P, Bard H, Teasdale F, Grignon A. The importance of an antenatal ultrasonographic diagnosis of correctable fetal malformations. Am J Obstet Gynecol. 1983, 15: 33-39
  • Harrison, HR, Golbus MS, Filly RA
  • Management of the fetus with a correctable congenital defect. JAMA 1981, 246: 774-779
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ayşegül Celayir This is me

Publication Date May 1, 2006
Published in Issue Year 2006 Volume: 37 Issue: 4

Cite

APA Celayir, A. (2006). Prenatal tanılı anomalilerde perinatal yaklaşım. Zeynep Kamil Tıp Bülteni, 37(4), 113-117. https://doi.org/10.16948/zktb.37366
AMA Celayir A. Prenatal tanılı anomalilerde perinatal yaklaşım. Zeynep Kamil Tıp Bülteni. May 2006;37(4):113-117. doi:10.16948/zktb.37366
Chicago Celayir, Ayşegül. “Prenatal tanılı Anomalilerde Perinatal yaklaşım”. Zeynep Kamil Tıp Bülteni 37, no. 4 (May 2006): 113-17. https://doi.org/10.16948/zktb.37366.
EndNote Celayir A (May 1, 2006) Prenatal tanılı anomalilerde perinatal yaklaşım. Zeynep Kamil Tıp Bülteni 37 4 113–117.
IEEE A. Celayir, “Prenatal tanılı anomalilerde perinatal yaklaşım”, Zeynep Kamil Tıp Bülteni, vol. 37, no. 4, pp. 113–117, 2006, doi: 10.16948/zktb.37366.
ISNAD Celayir, Ayşegül. “Prenatal tanılı Anomalilerde Perinatal yaklaşım”. Zeynep Kamil Tıp Bülteni 37/4 (May 2006), 113-117. https://doi.org/10.16948/zktb.37366.
JAMA Celayir A. Prenatal tanılı anomalilerde perinatal yaklaşım. Zeynep Kamil Tıp Bülteni. 2006;37:113–117.
MLA Celayir, Ayşegül. “Prenatal tanılı Anomalilerde Perinatal yaklaşım”. Zeynep Kamil Tıp Bülteni, vol. 37, no. 4, 2006, pp. 113-7, doi:10.16948/zktb.37366.
Vancouver Celayir A. Prenatal tanılı anomalilerde perinatal yaklaşım. Zeynep Kamil Tıp Bülteni. 2006;37(4):113-7.