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J Turk Ger Gynecol Assoc. 2018 Aug 6. doi: 10.4274/jtgga.2018.0079. [Epub ahead of print]

Congenital central nervous system anomalies: the 10-year single center experience on a challenging issue in perinatal medicine.

Author information

1
Kayseri Education and Research Hospital, Department of Obstetrics and Gynecology, Kayseri, Turkey.
2
Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
3
Hacettepe University Faculty of Medicine, Department of Child Health and Diseases, Neonatology Unit, Ankara, Turkey.

Abstract

OBJECTIVE:

Our goal is to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing our clinic's experience.

MATERIAL AND METHODS:

We evaluated prenatal findings and postnatal outcomes of neonates who had a CNS anomaly diagnosis in our clinic over a ten-year period. A total of 183 cases with various CNS anomalies were included in the study. Birth or termination preferences of mothers were recorded in all cases, and postnatal diagnosis concordance and prognosis after surgical procedures were evaluated in mothers who chose to continue the pregnancy.

RESULTS:

The mean maternal age was 28.2±5.5 years, mean gravida was 2.2±1.3, and the mean gestational age at diagnosis was 30.5±5.5 weeks. Seventy five out of 183 (41%) patients chose to terminate their pregnancy. Twenty babies (26.6%) in the termination of pregnancy group had additional anomalies. A hundred and eight patients gave birth at our institution. Mean birth weight was 3060±647.5 g, mean gestational week at delivery was 37.9±1.7 weeks, and mean APGAR score (5th minute) was 8.8±2.3. Four neonates died at the postpartum first day. The postnatal diagnosis of 60 of the 108 (55.5%) patients who gave birth was concordant with the prenatal diagnosis, and 32 of the 108 (29.6%) babies underwent surgical interventions.

CONCLUSION:

CNS anomalies have broad spectrum and variable prognoses. This study highlights the limitations of prenatal diagnoses, and the need for parents to have this information in order to determine the course of their pregnancy and prepare themselves for the postnatal challenging treatment/rehabilitation process.

KEYWORDS:

assessment; central nervous system; congenital abnormalities; neurosurgical procedure prenatal diagnosis.

PMID:
30115609
DOI:
10.4274/jtgga.2018.0079
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