Severity of abnormality influences decision to terminate pregnancies affected with fetal neural tube defects

Chris Grevengood*, Lee P. Shulman, Jeffrey S. Dungan, Paula Martens, Owen P. Phillips, Donald S. Emerson, Richard E. Felker, Joe Leigh Simpson, Sherman Elias

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

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 α-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.

Original languageEnglish (US)
Pages (from-to)273-277
Number of pages5
JournalFetal Diagnosis and Therapy
Volume9
Issue number4
DOIs
StatePublished - 1994

Keywords

  • Amniocentesis
  • Karyotype
  • Neural tube defect
  • Ultrasonography
  • α-Fetoprotein

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

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