Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Rates and subsequent clinical course of fetal congenital anomalies detected by prenatal targeted ultrasonography of 137 cases over 5 years in a single institute: a retrospective observational study

  • Haewon Choi (Department of Obstetrics and Gynecology, Rosemary's Hospital, Daegu) ;
  • Hyo-Shin Kim (Department of Obstetrics and Gynecology, Kyungpook National University Hospital) ;
  • Joon Sakong (Department of Occupational and Environmental Medicine, Yeungnam University Hospital)
  • Received : 2022.07.23
  • Accepted : 2022.09.22
  • Published : 2023.07.31
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Abstract

Background: With the establishment of international guidelines and changes in insurance policies in Korea, the role of targeted ultrasonography has increased. This study aimed to identify the rates and clinical course of anomalies detected using prenatal targeted ultrasonography. Methods: This study was a retrospective analysis of all pregnancies with targeted ultrasonography performed in a single secondary medical center over 5 years. Results: Fetal anomalies were detected by targeted ultrasonography in 137 of the 8,147 cases (1.7%). The rates of anomalies were significantly higher in female fetuses (2.0% vs. 1.3%). In cases of female fetuses, the rate of anomalies was significantly higher in the advanced maternal age group (2.4% vs. 1.2%). In cases of male fetuses, the rate of anomalies was significantly higher in nulliparous (2.4% vs. 1.5%) and twin (5.7% vs. 1.9%) pregnancies. Pulmonary anomalies were significantly more common in the multiparity group (17.6% vs. 5.8%). Among the 137 cases, 17.5% terminated the pregnancy, 16.8% were diagnosed as normal after birth, and 42.3% were diagnosed with anomalies after birth or required follow-up. Conclusion: Through the first study on the rates and clinical course of anomalies detected by targeted ultrasonography at a single secondary center in Korea, we found that artificial abortions were performed at a high rate, even for relatively mild anomalies or anomalies with good prognosis. We suggest the necessity of a nationwide study to establish clinical guidelines based on actual incidences or prognoses.

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References

  1. Grandjean H, Larroque D, Levi S. The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol 1999;181:446-54.  https://doi.org/10.1016/S0002-9378(99)70577-6
  2. Jiao S, Li H, Liu R, Wang S. The congenital malformation detection rate and the maternal satisfaction rate are improved using fetal systemic ultrasonography. Int J Clin Exp Med 2020;13:2520-6. 
  3. Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Andrade E, Johnsen SL, et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2011;37:116-26.  https://doi.org/10.1002/uog.8831
  4. Lee JE, Jung KL, Kim SE, Nam SH, Choi SJ, Oh SY, et al. Prenatal diagnosis of congenital heart disease: trends in pregnancy termination rate, and perinatal and 1-year infant mortalities in Korea between 1994 and 2005. J Obstet Gynaecol Res 2010;36:474-8.  https://doi.org/10.1111/j.1447-0756.2010.01222.x
  5. Jang HI, Choi JS, Song ES, Choi YY. Changes in birth rate, perinatal risk factors and outcome in newborns in multi-cultural family: ten-year experience in one center. Neonatal Med 2013;20:146-54.  https://doi.org/10.5385/nm.2013.20.1.146
  6. Hothi DK, Wade AS, Gilbert R, Winyard PJ. Mild fetal renal pelvis dilatation: much ado about nothing? Clin J Am Soc Nephrol 2009;4:168-77.  https://doi.org/10.2215/CJN.00810208
  7. Digiovanni LM, Quinlan MP, Verp MS. Choroid plexus cysts: infant and early childhood developmental outcome. Obstet Gynecol 1997;90:191-4.  https://doi.org/10.1016/S0029-7844(97)00251-2
  8. Society for Maternal-Fetal Medicine (SMFM); Fox NS, Monteagudo A, Kuller JA, Craigo S, Norton ME. Mild fetal ventriculomegaly: diagnosis, evaluation, and management. Am J Obstet Gynecol 2018;219:B2-9.  https://doi.org/10.1016/j.ajog.2018.04.039
  9. Sekarski N, Meijboom EJ, Di Bernardo S, Ksontini TB, Mivelaz Y. Perinatal arrhythmias. Eur J Pediatr 2014;173:983-96.  https://doi.org/10.1007/s00431-014-2316-4
  10. Groen H, Bouman K, Pierini A, Rankin J, Rissmann A, Haeusler M, et al. Stillbirth and neonatal mortality in pregnancies complicated by major congenital anomalies: findings from a large European cohort. Prenat Diagn 2017;37:1100-11.  https://doi.org/10.1002/pd.5148
  11. Korean Statistical Information Service. Infant, maternal and perinatal mortality statistics [Internet]. Daejeon: Statistics Korea; 2021 [cited 2022 Jul 10]. https://kosis.kr/publication/publicationThema.do?pubcode=YD&move=gongDiv_YD. 
  12. Croen LA, Shaw GM. Young maternal age and congenital malformations: a population-based study. Am J Public Health 1995;85:710-3.  https://doi.org/10.2105/AJPH.85.5.710
  13. Hollier LM, Leveno KJ, Kelly MA, MCIntire DD, Cunningham FG. Maternal age and malformations in singleton births. Obstet Gynecol 2000;96(5 Pt 1):701-6.  https://doi.org/10.1097/00006250-200011000-00011
  14. Broere-Brown ZA, Adank MC, Benschop L, Tielemans M, Muka T, Goncalves R, et al. Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis. Biol Sex Differ 2020;11:26. 
  15. Black AJ, Lu DY, Yefet LS, Baird R. Sex differences in surgically correctable congenital anomalies: a systematic review. J Pediatr Surg 2020;55:811-20.  https://doi.org/10.1016/j.jpedsurg.2020.01.016
  16. Christensen K, McGue M. Chapter 26. Twin-singleton differences. In: Tarnoki AD, Tarnoki DL, Harris J, Segal NL, editors. Twin research for everyone: from biology to health, epigenetics, and psychology. Amsterdam: Academic Press; 2022. 
  17. Cui W, Ma CX, Tang Y, Chang V, Rao PV, Ariet M, et al. Sex differences in birth defects: a study of opposite-sex twins. Birth Defects Res A Clin Mol Teratol 2005;73:876-80.  https://doi.org/10.1002/bdra.20196
  18. McNeese ML, Selwyn BJ, Duong H, Canfield M, Waller DK. The association between maternal parity and birth defects. Birth Defects Res A Clin Mol Teratol 2015;103:144-56.  https://doi.org/10.1002/bdra.23360
  19. Korean Statistical Information Service. Vital statistics of immigrants in 2020 [Internet]. Daejeon: Statistics Korea; 2021 [cited 2022 Jul 10]. https://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode= read&aSeq= 414976. 
  20. Halvaei I, Litzky J, Esfandiari N. Advanced paternal age: effects on sperm parameters, assisted reproduction outcomes and offspring health. Reprod Biol Endocrinol 2020;18:110. 
  21. Akinmoladun JA. Termination of pregnancy for ultrasound diagnosed major fetal anomalies at a nigerian tertiary hospital: an initial experience. West Afr J Med 2021;38:738-42. 
  22. Kamranpour B, Noroozi M, Bahrami M. Termination of pregnancy for fetal anomalies: a qualitative study of the informational and educational needs of women. Iran J Nurs Midwifery Res 2021;26:97-103. https://doi.org/10.4103/ijnmr.IJNMR_94_20