胎儿诊断为三体 13 或 18 后进行的产前咨询和父母决策。
Prenatal counseling and parental decision-making following a fetal diagnosis of trisomy 13 or 18.
机构信息
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA.
出版信息
J Perinatol. 2018 Jul;38(7):788-796. doi: 10.1038/s41372-018-0107-x. Epub 2018 May 8.
OBJECTIVES
To evaluate parental decisions following a prenatal diagnosis of trisomy 13 (T13) or trisomy 18 (T18), prenatal counseling received, and pregnancy outcomes.
STUDY DESIGN
Single-center, retrospective cohort study of families with a prenatal diagnosis of T13 or T18 from 2000 to 2016.
RESULTS
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.
CONCLUSIONS
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.
目的
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。
研究设计
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。
结果
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。
结论
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。
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