Pediatric neurology participation in a fetal diagnostic service

Mark S. Scher, Brenda M. Kidder, Dinesh Shah, Barbara A. Bangert, Nancy E. Judge

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Fetal neurologic consultations were provided to 166 maternal-fetal pairs over a 5-year period. Consultations were initiated during the second trimester in 46% (74/166) of pairs. Fifty-percent (83/166) of these consultations involved brain malformations, of which 55% (46/83) were also associated with other organ abnormalities. Brain malformations principally consisted of encephalocele, dorsal neural tube defects, holoprosencephaly, schizencephaly, cerebellar dysgenesis, and ventriculomegaly. Non-central nervous system organ system anomalies were observed in another 50% (83/166), in decreasing order of occurrence - cardiac, renal, gastrointestinal, pulmonary, in utero growth restriction, and hydrops fetalis. Outcome data on 128 children included survival at delivery for 86/128 or 67.2%, termination in 16/128 (12.5%), stillborn 6/128 (4.7%), and postnatal deaths in 20/128 (15.6%). Maternal medical histories were abnormal for 65% of women. Placental pathology was abnormal in 80% (72/102) of available specimens, consisting of both chronic and acute lesions. Postnatal diagnoses were obtained in 128 neonates; 64% (82/128) remained the same diagnosis, 28.1% (36/128) had a worse or improved diagnosis, and 10/128 (7.8%) were normal. Pediatric neurologists can provide useful fetal consultations early during gestation, and must consider multiple organ diagnoses and maternal-placental diseases. Postnatal diagnoses may be different from the fetal diagnoses which will influence continuity of care for the child at older ages. Scher MS, Kidder BM, Shah D, Bangert BA, Judge NE. Pediatric neurology participation in a fetal diagnostic service.

Original languageEnglish (US)
Pages (from-to)338-344
Number of pages7
JournalPediatric Neurology
Volume30
Issue number5
DOIs
StatePublished - May 2004
Externally publishedYes

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Diagnostic Services
Neurology
Pediatrics
Referral and Consultation
Mothers
Nervous System
Placenta Diseases
Holoprosencephaly
Encephalocele
Hydrops Fetalis
Continuity of Patient Care
Neural Tube Defects
Brain
Second Pregnancy Trimester
Newborn Infant
Pathology
Kidney
Pregnancy
Lung
Survival

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology

Cite this

Pediatric neurology participation in a fetal diagnostic service. / Scher, Mark S.; Kidder, Brenda M.; Shah, Dinesh; Bangert, Barbara A.; Judge, Nancy E.

In: Pediatric Neurology, Vol. 30, No. 5, 05.2004, p. 338-344.

Research output: Contribution to journalArticle

Scher, Mark S. ; Kidder, Brenda M. ; Shah, Dinesh ; Bangert, Barbara A. ; Judge, Nancy E. / Pediatric neurology participation in a fetal diagnostic service. In: Pediatric Neurology. 2004 ; Vol. 30, No. 5. pp. 338-344.
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