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Archives of Gynecology and Obstetrics

, Volume 298, Issue 5, pp 903–910 | Cite as

Termination of pregnancy following prenatally diagnosed central nervous system malformations

  • Christian M. Domröse
  • Sandra Bremer
  • Caroline Buczek
  • Annegret Geipel
  • Christoph Berg
  • Astrid Hellmund
  • Ulrich Gembruch
  • Arne Willruth
Maternal-Fetal Medicine
  • 44 Downloads

Abstract

Purpose

To analyze fetal cerebral malformations with late termination of pregnancy (TOP) and to evaluate the rate of cases that could have been detected earlier using international recommended requirements of sonographic examination of the fetal central nervous system (CNS).

Materials and methods

Cases of singleton pregnancies above 18 + 0 weeks of gestation ending in late TOP due to fetal CNS malformations between 2002 and 2011 were retrospectively reviewed. The cases were divided into isolated and non-isolated cerebral malformations. Prevalence and timing of TOP were assessed relative to the identified malformations.

Results

During this 10-year period, 212 (20.8%) out of 1017 late TOPs were performed in pregnancies with fetal cerebral malformations. 59 cases were excluded because of chromosomal anomalies. 86 (56.2%) of the remaining 153 cases were isolated cerebral malformations while 67 (43.8%) were non-isolated. TOP after viability (≥ 24 + 0 weeks of gestation) was performed in 61.4% (94/153). Substantial morbidity (n = 80; 52.3%) and mental retardation (n = 33, 38.4%) made up the leading prognostic groups. In about 80% of detectable anomalies, diagnosis of CNS malformation could have been made earlier by following international guidelines of fetal CNS examination at second trimester scan.

Conclusion

General implementation of ultrasound screening in maternity care can significantly reduce the number of late TOPs in Germany.

Keywords

Central nervous system Malformations Termination of pregnancy Ultrasound 

Notes

Author contributions

CD Manuscript writing, project development, data analysis, SB data collection and management, CB data collection and management, AG investigation, CB Investigation, AH investigation, UG project development, manuscript editing, AW manuscript editing, project development, data analysis.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This is a retrospective study of data routinely achieved and anonymously analyzed. Our local ethics committee (Ethikkommission an der Medizinischen Fakultät der Rheinischen Friedrich-Wilhelms-Universität Bonn) does not generate a protocol in this form of study but frees us from it. All findings were extracted from the medical records and stored in an anonymized data base.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Christian M. Domröse
    • 1
    • 2
  • Sandra Bremer
    • 1
  • Caroline Buczek
    • 1
  • Annegret Geipel
    • 1
  • Christoph Berg
    • 1
    • 2
  • Astrid Hellmund
    • 1
  • Ulrich Gembruch
    • 1
  • Arne Willruth
    • 1
  1. 1.Department of Obstetrics and Prenatal MedicineUniversity of BonnBonnGermany
  2. 2.Department of Obstetrics and GynecologyUniversity of CologneCologneGermany

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