Does prenatal counseling for pregnancies complicated by multiple fetal abnormalities concord with postnatal outcomes?
Does prenatal counseling for pregnancies complicated by multiple fetal abnormalities concord with postnatal outcomes?
复制标题
DOI：
10.1002/pd.5636
复制
发表时间：
2020-04-01
影响因子：
3
通讯作者：
Acharya, Krishna
中科院分区：
文献类型：
--
作者：
Baker, Anna;Lagatta, Joanne;Acharya, Krishna
目的探讨妊娠合并多胎畸形的产前预后与产后结局的一致性。方法回顾性队列研究2015 - 2018年威斯康星州胎儿关注中心（FCCW）多胎畸形妊娠的资料。我们回顾了异常的记录，给出了预后的严重程度和产后结果。结果在85例多胎畸形孕妇中，48%的孕妇预后为“可能死亡”，19%的孕妇预后为“严重损害”。在被告知“可能死亡”后继续怀孕的情况下，尽管进行了医疗干预，但除了一个病例外，其他病例的结局都是一致的。在被咨询为“严重损害”的妊娠中，88%的病例更常见的结局是死亡或严重损害，33%的病例在严重损害的情况下存活。产后结果与产前严重程度一致的情况下，68%，更严重的20%的情况下，和不太严重，在不到5%的cases.Conclusion产前预测严重的结果通常是真实的妊娠并发多种异常。在结果不一致的情况下，结果往往比预测的更严重。
Objective In pregnancies complicated by multiple fetal abnormalities, our objective was to determine the degree of concordance between prenatal prognosis and postnatal outcomes.Method Retrospective cohort study of pregnancies with multiple fetal abnormalities referred to the Fetal Concerns Center of Wisconsin (FCCW) from 2015 to 2018. We reviewed records for anomalies, given prognostic severity, and postnatal outcomes. Prognostic severity was categorized as "likely mortality," "severe impairment," "moderate," and "mild" based on predetermined criteria.Results In 85 pregnancies with multiple fetal abnormalities, 48% were given a prognosis of "likely mortality," and 19% were given a prognosis of "severe impairment." In pregnancies that were continued after being counseled as "likely mortality," this outcome was concordant in all but one case, despite medical interventions. In pregnancies counseled as "severe impairment," the more common outcome was mortality or severe impairment in 88% of cases and survival with severe impairment in 33% of cases. Postnatal outcomes were concordant with prenatal severity in 68% of the cases, more severe in 20% of the cases, and less severe in fewer than 5% of cases.Conclusion Prenatal predictions about severe outcomes are usually true in pregnancies complicated by multiple abnormalities. In cases of outcome discordance, outcomes tend to be more severe than predicted.