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Titolo:
Selective termination for structural, chromosomal, and mendelian anomalies: International experience
Autore:
Evans, MI; Goldberg, JD; Horenstein, J; Wapner, RJ; Ayoub, MA; Stone, J; Lipitz, S; Achiron, R; Holzgreve, W; Brambati, B; Johnson, A; Johnson, MP; Shalhoub, A; Berkowitz, RL;
Indirizzi:
Wayne State Univ, Dept Obstet & Gynecol, Detroit, MI USA Wayne State UnivDetroit MI USA , Dept Obstet & Gynecol, Detroit, MI USA Calif Pacific Med Ctr, Dept Obstet & Gynecol, San Francisco, CA USA Calif Pacific Med Ctr San Francisco CA USA ynecol, San Francisco, CA USA Calif Hosp Med Ctr, Dept Obstet & Gynecol, Los Angeles, CA USA Calif Hosp Med Ctr Los Angeles CA USA tet & Gynecol, Los Angeles, CA USA Thomas Jefferson Univ, Dept Obstet & Gynecol, Philadelphia, PA 19107 USA Thomas Jefferson Univ Philadelphia PA USA 19107 hiladelphia, PA 19107 USA Mt Sinai Med Ctr, New York, NY 10029 USA Mt Sinai Med Ctr New York NY USA10029 ai Med Ctr, New York, NY 10029 USA Chaim Sheba Med Ctr, Dept Obstet & Gynecol, Tel Aviv, Israel Chaim Sheba Med Ctr Tel Aviv Israel Obstet & Gynecol, Tel Aviv, Israel Univ Basel, Dept Obstet & Gynecol, Basel, Switzerland Univ Basel Basel Switzerland Dept Obstet & Gynecol, Basel, Switzerland Univ Milan, Dept Obstet & Gynecol, Milan, Italy Univ Milan Milan ItalyUniv Milan, Dept Obstet & Gynecol, Milan, Italy
Titolo Testata:
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
fascicolo: 4, volume: 181, anno: 1999,
pagine: 893 - 897
SICI:
0002-9378(199910)181:4<893:STFSCA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
UMBILICAL-CORD LIGATION; MULTIPLE GESTATIONS; TWIN PREGNANCIES; FETUS; MANAGEMENT; FETOSCOPY;
Keywords:
selective termination; fetal abnormalities; prenatal diagnosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Evans, MI Hutzel Hosp, Dept Obstet & Gynecol, 4707 St Antoine, Detroit, MI48201 USA Hutzel Hosp 4707 St Antoine Detroit MI USA 48201 t, MI 48201 USA
Citazione:
M.I. Evans et al., "Selective termination for structural, chromosomal, and mendelian anomalies: International experience", AM J OBST G, 181(4), 1999, pp. 893-897

Abstract

OBJECTIVE: Our purpose was to evaluate the outcomes of selective termination for fetal anomalies at 8 centers with the largest known experiences worldwide. STUDY DESIGN: Outcomes in 402 cases of selective termination in pregnancies with dizygotic twins from 8 centers in 4 countries were analyzed by year,gestational age at procedure, and indication. Reductions of fetuses were as follows: 2 to 1, n = 345; 3 to 2, 39; greater than or equal to 4 to 2 or 3, n = 18. Potassium chloride was used in all procedures. RESULTS: Selective termination resulted in delivery of a viable infant or infants in >90% of cases. Loss up to 24 weeks occurred in 7.1% of cases in which the final result was a singleton fetus and in 13.0% of cases in whichthe final result was twins. Loss was 6.6% as a result of structural abnormalities, 7.0% for chromosomal abnormalities, and 10% for mendelian abnormalities (difference not statistically significant). Loss rates for procedureswere as follows: 9-12 weeks, 5.4%; 13-18 weeks, 8.7%; 19-24 weeks, 6.8%; and greater than or equal to 25 weeks, 9.1% (difference not statistically significant). Mean gestational age at delivery was 35.7 weeks. No differenceswere seen in outcomes by maternal age. The rate of very early premature deliveries has fallen in recent years. There were no known cases of disseminated intravascular coagulation or serious maternal complications. CONCLUSION: (1) Selective termination, in the most experienced hands, can be technically performed in all 3 trimesters with good outcomes in >90% of cases. (2) The previously observed increase in second- versus first-trimester losses has diminished. (3) Third-trimester procedures, where legal, can be performed with a good outcome for the surviving fetus.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/10/20 alle ore 00:33:13