[Prenatal diagnosis of congenital anomalies requiring surgical management in the Lower Silesia--fact or fiction?].
In order to assess the current status of prenatal diagnosis of congenital anomalies requiring surgical management in the area of Lower Silesia, a retrospective study of medical charts of all neonates admitted to the Department of Paediatric Surgery in Wrocław between 1997 and 2000 was undertaken. 218 babies affected by anomalies detectable antenatally by conventional ultrasound scan were subjected to the further study. Neural tube defects and abdominal wall defects were the most common and were diagnosed in 63 and 38 children respectively. The incidence of other congenital anomalies; hydrocephalus, oesophageal, duodenal and intestinal atresia, diaphragmatic hernia and urinary tract anomalies was similar in each group. The suspicion of anatomical defect or its precise recognition was made antenatally in 52 pregnancies (23.8%). The highest rate of positive prenatal diagnosis was noted among babies with hydrocephalus (50%) and urinary tract anomalies (42.8%). In other groups this rate was significantly less. Critical analysis of postnatal management in studied cases revealed that the babies with atresia of gastrointestinal tract, congenital diaphragmatic hernia and abdominal wall defects were negatively affected by a lack of prenatal recognition of the defect. Moreover, in more than 40% of all analysed pregnancies presence of risk factors (positive family history, course of pregnancy, mother's age, polyhydramnios, oligohydramnios, previous abnormal pregnancies) were identified that should have prompted an obstetrician to a through diagnostic evaluation of the foetus. The obtained results clearly indicate the necessity for the elaboration of a new protocol of antenatal care of pregnant women in the Lower Silesia. In case of suspected anomaly amenable to operative correction within the first days of life, paediatric surgeon should be an active member of a specialist team responsible for care of mother and her baby.
Bagłaj
Maciej
M
Katedra i Klinika Chirurgii i Urologii Dzieciecej AM we Wrocławiu.
Czernik
Jerzy
J
Patkowski
Dariusz
D
D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D010819:Physician's Role; D011044:Poland / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011295:Prenatal Care / Q000592:standards*; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012307:Risk Factors