Parental counselling and autopsy results: A retrospective diagnostic cohort study at a multidisciplinary fetal neurology clinic.

IF 4.3 2区医学 Q1 CLINICAL NEUROLOGY

Developmental Medicine and Child Neurology Pub Date : 2025-08-21 DOI:10.1111/dmcn.16471

Avi Shariv, Michal Gafner, Zvi Leibovitz, Letizia Schreiber, Dvora Kidron, Ayala Arad, Efrat Hadi, Stephanie Libzon, Liat Ben Sira, Maya Goldschmidt Manor, Dorit Lev, Tally Lerman-Sagie, Liat Gindes

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引用次数: 0

Abstract

Aim: To examine the accuracy of prenatal counselling at a multidisciplinary fetal neurology clinic (FNC) that led to termination of pregnancy (TOP), to improve the quality of future consultations.

Method: This retrospective diagnostic cohort study compared the imaging (neurosonography and intrauterine magnetic resonance imaging) of fetuses evaluated at our FNC between 2009 and 2019, which underwent TOP because of brain anomalies, to the autopsy reports for concordance. The degrees of concordance were full, partial, and discordant.

Results: We identified 114 fetuses aborted because of brain anomalies, which underwent autopsy. All consultations were provided at the late stages of pregnancy, with 70% given in the third trimester and a mean gestational age of 29 weeks (range = 18-39, SD = 5). The imaging and autopsy results were fully or partially concordant in 96% of cases. Discordance was found in four fetuses, but termination was considered unjustified in only one. Microscopic evaluation of the fetal brain provided valuable information in 41% of fetuses and changed the diagnosis in 13%.

Interpretation: We found excellent concordance between the imaging and autopsy findings. We suggest that an autopsy is crucial for learning and delivering correct consultations to patients and planning their subsequent pregnancies.

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父母咨询和尸检结果：一个多学科胎儿神经病学诊所的回顾性诊断队列研究。

目的：探讨多学科胎儿神经病学诊所（FNC）产前咨询导致终止妊娠（TOP）的准确性，以提高未来咨询的质量。方法：本回顾性诊断队列研究将2009年至2019年在FNC评估的胎儿的影像学（神经超声和宫内磁共振成像）与尸检报告的一致性进行了比较，这些胎儿因脑异常而接受了TOP检查。和谐的程度分为完全、部分和不和谐。结果：我们发现了114例因脑异常而流产的胎儿，并对其进行了尸检。所有咨询均在妊娠晚期提供，70%在妊娠晚期进行，平均胎龄为29周（范围= 18-39,SD = 5）。96%的病例的影像学和尸检结果完全或部分一致。在四个胎儿中发现了不一致，但只有一个胎儿被认为是不合理的。在41%的胎儿中，胎儿大脑的显微评估提供了有价值的信息，13%的胎儿改变了诊断。解释：我们发现影像和尸检结果非常吻合。我们建议尸检是至关重要的学习和提供正确的咨询，以病人和计划他们的后续怀孕。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Developmental Medicine and Child Neurology 医学-临床神经学

CiteScore

7.80

自引率

13.20%

发文量

338

审稿时长

3-6 weeks

期刊介绍： Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.