Management of pregnancy and labour in cases diagnosed with major fetal malformation.
OBJECTIVE
To explore the obstetrical management of pregnancies with severe fetal malformations, taking into account the rapid improvement in ultrasound technology and interventional possibilities.


RESULTS
Unique studies using modern ultrasound techniques describe the evolution of spina bifida and the subsequent varying development of hydrocephalus. In addition, the dilated fetal stomach is shown to be an ominous sign of complications in cases of gastroschisis. Such complications can be decreased by prenatal supervision using cardiotocography, which detects signs of fetal distress. Recent studies confirm previous findings that caesarean section does not improve the outcome in cases of fetal gastroschisis or spina bifida.


CONCLUSIONS
Recent research has demonstrated the development of severe fetal malformations. New studies have shown the positive effects of fetal supervision in cases of gastroschisis. Furthermore, caesarean section is not beneficial compared with vaginal delivery in such cases. Fetal surgery is still undergoing rapid development and has the potential to improve outcome in the near future.
Lingman
Göran
G
Department of Obstetrics and Gynecology, University Hospital of Lund, Lund, Sweden. goran.lingman@skane.se
D018376:Cardiovascular Abnormalities / Q000175:diagnosis; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D005315:Fetal Diseases / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D016135:Spinal Dysraphism / Q000175:diagnosis; D016216:Ultrasonography, Prenatal; D014564:Urogenital Abnormalities / Q000175:diagnosis