Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA.
J Perinatol. 2018 Jul;38(7):788-796. doi: 10.1038/s41372-018-0107-x. Epub 2018 May 8.
To evaluate parental decisions following a prenatal diagnosis of trisomy 13 (T13) or trisomy 18 (T18), prenatal counseling received, and pregnancy outcomes.
Single-center, retrospective cohort study of families with a prenatal diagnosis of T13 or T18 from 2000 to 2016.
Out of 152 pregnancies, 55% were terminated. Twenty percent chose induction with palliative care, 20% chose expectant management, 2% chose full interventions, and 3% were lost to follow-up. Counseling was based on initial parental goals, but most women were given options besides termination. Women who chose expectant management had a live birth in 50% of the cases. Women who chose neonatal interventions had a live birth in 100% of the cases, but there were no long-term survivors.
The majority of women who continue their pregnancy after a fetal diagnosis of T13 or T18 desire expectant management with palliative care. A live birth can be expected at least half of the time.
评估在产前诊断出三体 13 号染色体(T13)或三体 18 号染色体(T18)后父母的决定、接受的产前咨询以及妊娠结局。
对 2000 年至 2016 年间在单中心接受 T13 或 T18 产前诊断的家庭进行的回顾性队列研究。
在 152 例妊娠中,55%被终止。20%选择引产加姑息治疗,20%选择期待管理,2%选择全面干预,3%失访。咨询是基于初始父母的目标,但大多数女性都有除终止妊娠以外的选择。选择期待管理的女性中有 50%的活产。选择新生儿干预的女性中有 100%的活产,但没有长期存活者。
大多数在胎儿诊断出 T13 或 T18 后继续妊娠的女性希望进行期待管理加姑息治疗。至少有一半的情况下可以期待活产。