Mid-pregnancy genetic terminations of pregnancy--postnatal assessment and management.
OBJECTIVE
To assess the need for and ability to apply a postnatal assessment protocol (PNAP), consisting of clinical examination, photographs, radiographs, chromosomal analysis and postmortems, of fetuses from mid-pregnancy genetic terminations of pregnancy.


METHODS
Prospective hospital-based study.


METHODS
The maternity unit at the Pretoria Academic Hospital.


RESULTS
Fifty consecutively delivered fetuses were assessed by means of the PNAP after genetic termination of pregnancy. A definitive prenatal diagnosis was available in 17 (34%) cases. In 33 (66%) cases the termination was undertaken on the basis of a provisional prenatal diagnosis which was confirmed postnatally in 12 (24%) cases; a definitive postnatal diagnosis could not be confirmed in 5 (10%) cases. In the remaining 16 (32%) cases a totally different postnatal diagnosis was obtained. The definitive postnatal diagnoses in the 28 cases with provisional prenatal diagnoses were confirmed by clinical examination in 13 (26%), by chromosomal analysis in 7 (14%), by postmortem in 5 (10%) and with radiographs in 3 (6%). On retrospective analysis, 22 of the 33 provisional prenatal diagnoses could have been confirmed using available radiographs, chromosome results and photographs only.


CONCLUSIONS
Genetic terminations of pregnancy are a subgroup of stillbirths for which a PNAP is essential to ensure that appropriate postnatal genetic counselling can be given to the parent(s).
Department of Human Genetics, University of Pretoria.
A L
AL
Christianson
H J
HJ
van den Berg
P
P
van Rensburg
E
E
Myburgh
H
H
Kruger
I W
IW
Simson
D000029:Abortion, Legal / Q000592:standards; D000032:Abortion, Therapeutic; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D011181:Postnatal Care; D011247:Pregnancy; D011446:Prospective Studies