Grevengood C, Shulman L P, Dungan J S, Martens P, Phillips O P, Emerson D S, Felker R E, Simpson J L, Elias S
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103-2896.
Fetal Diagn Ther. 1994 Jul-Aug;9(4):273-7. doi: 10.1159/000263947.
We examined parental decision concerning pregnancy management in women having fetuses with neural tube defects (NTDs) to determine whether severity of defect or method of detection has an impact on the decision making process. Analysis of decisions by 50 women, whose pregnancies were affected by an isolated neural tube defect (NTD) and characterized by a singleton gestation at 24 gestational weeks or less with normal chromosomal complement (46,XX or 46,XY), were assessed. All 23 women carrying fetuses with anencephaly elected to terminate their pregnancies. Of the 27 women carrying fetuses with spina bifida, 21 (77.8%) elected to terminate their pregnancies and 6 (22.2%) elected to continue their pregnancies. Of the 6 pregnancies that were continued, 4 were initially detected by ultrasonography and 2 were ascertained by maternal serum alpha-fetoprotein screening; defects ranged from 2 to 14 vertebral bodies, and none of the defects were craniad to the T9 level. This is in comparison to 5 of the 21 spina bifida cases that were elective pregnancy terminations, which were characterized by fetal lesions craniad to the T9 level. Severity of NTD thus appears to influence the decision to continue or terminate an affected pregnancy.
我们研究了患有神经管缺陷（NTDs）胎儿的孕妇妊娠管理方面的父母决策，以确定缺陷的严重程度或检测方法是否会对决策过程产生影响。对50名孕妇的决策进行了分析，这些孕妇的妊娠受到孤立性神经管缺陷（NTD）影响，其特征为单胎妊娠，妊娠周数在24周及以下，染色体组型正常（46,XX或46,XY）。所有23名怀有无脑儿胎儿的孕妇均选择终止妊娠。在27名怀有脊柱裂胎儿的孕妇中，21名（77.8%）选择终止妊娠，6名（22.2%）选择继续妊娠。在继续妊娠的6例中，4例最初通过超声检查发现，2例通过母体血清甲胎蛋白筛查确诊；缺陷范围为2至14个椎体，且无一例缺陷位于T9水平以上。相比之下，在21例选择性终止妊娠的脊柱裂病例中，有5例的特征是胎儿病变位于T9水平以上。因此，NTD的严重程度似乎会影响继续或终止受影响妊娠的决策。
