Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Ireland.
Prenat Diagn. 2010 Apr;30(4):357-60. doi: 10.1002/pd.2490.
Early elective termination of pregnancy is the most common outcome of a diagnosis of anencephaly in developed countries. Experience and expertise with management of ongoing pregnancies is limited. We aimed to investigate the natural history of these pregnancies from diagnosis to delivery and to determine timing of death.
A retrospective review of cases of anencephaly diagnosed between 2003 and 2009 in tertiary-referral university teaching hospitals in Cork.
The majority of cases (25/26; 96%) were diagnosed prenatally at a median gestation of 21(+2) weeks (range 13(+4)-32(+4)). The median maternal age was 30 years (range 17-41) and 50% were primigravidae. Seven pregnancies were complicated by polyhydramnios and four deliveries were complicated by shoulder dystocia. The median gestation at delivery was 35 weeks (range 22(+5)-42(+6)); 69% of labours were induced at a median gestation of 34 weeks. Six women (6/26; 23%) had a pre-labour intrauterine fetal death and nine women (9/26; 35%) had an intrapartum fetal death. Median neonatal survival time was 55 min (range 10 min to 8 days). Six parents donated neonatal organs for transplantation.
This study provides useful information for health professionals caring for patients with a diagnosis of anencephaly. The majority of these infants die prior to delivery but short-term survival is possible.
在发达国家，诊断无脑畸形后最常见的结果是早期选择性终止妊娠。对于持续妊娠的管理经验和专业知识有限。我们旨在调查这些妊娠从诊断到分娩的自然史，并确定死亡的时间。
对 2003 年至 2009 年间在科克三级转诊大学教学医院诊断的无脑畸形病例进行回顾性分析。
大多数病例（25/26；96%）在妊娠中期 21（+2）周（范围 13（+4）-32（+4））时被产前诊断。母亲的中位年龄为 30 岁（范围 17-41），其中 50%为初产妇。7 例妊娠并发羊水过多，4 例分娩并发肩难产。中位分娩孕周为 35 周（范围 22（+5）-42（+6））；69%的分娩在中位妊娠 34 周时引产。6 名妇女（6/26；23%）在产前发生宫内胎儿死亡，9 名妇女（9/26；35%）在分娩时发生胎儿死亡。新生儿中位存活时间为 55 分钟（范围 10 分钟至 8 天）。6 名家长为新生儿捐献器官进行移植。
本研究为照顾无脑畸形诊断患者的医疗保健专业人员提供了有用的信息。这些婴儿中的大多数在分娩前死亡，但短期存活是可能的。
