Antenatal Diagnosis of Fetal Abnormalities by N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian PDF

By N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian Donnai MBBS, FRCP, DCH, DObst, RCOG (eds.)

ISBN-10: 1447118545

ISBN-13: 9781447118541

ISBN-10: 1447118561

ISBN-13: 9781447118565

In few components of medication is development extra astonishing than within the box of prenatal analysis. New medical strategies corresponding to chorion villus sampling, distinct ultrasound scanning and cordocentesis are being evaluated by way of obstetricians, and refinement of biochemical trying out is widening the scope of maternal serum screening. within the laboratory, dramatic advances in molecular biology are happening: households susceptible to genetic ailment may be investigated with gene probes, and preimplantation prognosis of the embryo is now becom­ ing a truth. those technical advances have very important moral and useful implications, between with a purpose to be one more raise in public expectancies of the criteria required of antenatal providers. Clini­ cians will want a excessive measure of ability to notify fit ladies concerning the techniques for screening general pregnancies, and to suggestions high-risk girls concerning the advantages and barriers of prenatal prognosis. Obstetricians, scientists and well-being carrier managers will face the tough activity of finding out how prenatal analysis might be made on hand to girls in a worrying and affordable approach. Recognising the swift growth during this box, the Royal university of Obstetricians and Gynaecologists made prenatal prognosis the topic of its twenty third learn team. a global panel of prime researchers, whose services ranged from molecular biology to philosophy, was once invited to take part in a 3 day workshop, with time for in-depth dialogue in addition to the presentation of papers.

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Extra info for Antenatal Diagnosis of Fetal Abnormalities

Sample text

So even if the termination is not notified, it gets picked up. The surprising thing was anencephaly, which seems to be running quite level for the last five years. But that is over 200000 births, perhaps not enough. J. Harris: Are any steps taken to tell patients of the false positive and false negative rates affecting centres where testing is done? Are mothers or families told that the diagnosis in the test has been confirmed or otherwise on postmortem examination? Atkins: I can answer that for us but it would have to be done specifically for each of the problems.

The Potential for In Utero Treatment One of the potential benefits of screening for anomalies is that it may allow the identification of a group of babies for whom treatment in utero, usually in the form of shunting procedures, may be appropriate. A review of cases in which shunts had been used both in hydrocephalus and in obstructive uropathy suggested that shunting in the former was not helpful whereas in the latter some improvement was observed [11]. The matter is controversial but one of the problems with the available literature is that clearly defined diagnostic groups have not been established, which makes comparisons impossible.

Here the purpose of screening becomes less clear since all it might achieve is the generation of worry and anxiety in the parents, and the advantages of prenatal warning may seem of dubious value. Probably the greatest value of screening is the identification of lesions which lead to long-term morbidity, and probably the two best examples of this are spina bifida and serious cardiac anomalies. The efficacy of screening in the detection of spina bifida has been assessed and although specificity and sensitivity can be around 100% in units dedicated to scanning [8], things are less clear for Routine Fetal Anomaly Screening 39 departments in which, perhaps, equipment and staffing levels are less favourable.

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Antenatal Diagnosis of Fetal Abnormalities by N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian Donnai MBBS, FRCP, DCH, DObst, RCOG (eds.)


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