title: Delivery modes in case of fetal malformations.
abstract: An estimated 276,000 babies die within 4 weeks of birth every year, worldwide, from congenital anomalies. Better quality ultrasound screening can increase the detection of these fetal malformations in the prenatal period. Prenatal counseling for the pregnant woman and her family, regarding the nature of the disease and prognosis is necessary. Options for management in prenatal, perinatal, intrapartum, neonatal, and childhood periods need to be thoroughly discussed, so that the family can make an informed decision. A multidisciplinary approach is usually needed once a decision has been made to optimize fetal outcome, to plan for the timing and location as well as the mode of delivery. In most of the cases, vaginal delivery can be attempted. An elective cesarean delivery should be reserved for maternal concern of dystocia, certain fetal conditions that cesarean delivery will optimize perinatal outcome, or if the parents have a psychosocial determination to have a live-born infant.
authors.affiliation: Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Department of Obstetrics and Gynecology, 2 Prannok Road, Bangkoknoi, Bangkok.
authors.forename: Tuangsit
authors.initials: T
authors.lastname: Wataganara
authors.affiliation: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY.
authors.forename: Amos
authors.initials: A
authors.lastname: Grunebaum
authors.affiliation: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY.
authors.forename: Frank
authors.initials: F
authors.lastname: Chervenak
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Wielgos
mesh_terms: D002585:Cesarean Section; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000628:therapy*; D003376:Counseling; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011296:Prenatal Diagnosis
keywords: Cesarean delivery; congenital anomaly; ethics; vaginal delivery