Problem-based learning| Volume 18, ISSUE 5, P134-138, May 2008

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Suspected fetal anomalies


      Major structural abnormalities affect 2–3% of pregnancies, but they represent a much higher proportion of perinatal mortality. Detection of many congenital anomalies has increased due to improved antenatal ultrasound diagnosis. This enables fetal medicine specialists to look for other associated structural anomalies, test for chromosomal or genetic abnormalities, offer fetal therapy in selected cases, and predict long-term outcome. In conjunction with other specialists, this facilitates improved parental counselling and permits parents to make choices regarding continuation of pregnancy and allows preparation for the complex postnatal course. This contribution discusses four relatively common congenital abnormalities (talipes, exomphalos, gastroschisis, congenital diaphragmatic hernia) which require ongoing care in the antenatal setting and on the labour ward by obstetricians.


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      Further reading

        • Carroll S.G.M.
        • Lockyer H.
        • Andrews H.
        • et al.
        Outcome of fetal talipes following in utero sonographic diagnosis.
        Ultrasound Obstet Gynecol. 2001; 18: 437-440
        • Midrio P.
        • Stefanutti G.
        • Mussap M.
        • D’Antona D.
        • Zolpi E.
        • Gamba P.
        Amnioexchange for fetuses with gastroschisis: is it effective?.
        J Pediatr Surg. 2007; 42: 777-782
      1. Offerdal K, Jebens N, Blaas HGK, Eik-Nes SH. Prenatal ultrasound detection of talipes equinovarus in a non-selected population of 49 314 deliveries in Norway. Ultrasound Ostet Gynecol. Published online in Wiley InterScience doi: 10.1002/uog.4079.

        • Tillett R.L.
        • Fisk N.M.
        • Murphy K.
        • Hunt D.M.
        Clinical outcome of congenital talipes equinovarus diagnosed antenatally by ultrasound.
        J Bone Joint Surg. 2000; 82-B: 876-880
        • Stone P.
        Fetal gastrointestinal abnormalities.
        in: James D.K. Steer P.J. Weiner C.P. Gonik B. High risk pregnancy. Management options. 3rd edn. Philadelphia, 2006: 422-433 ([Chapter 20])