Artikel
Long-term follow-up and neurosurgical interventions in patients with a malformation of the central nervous system identified with prenatal screening
Langzeitergebnisse und neurochirurgische Interventionen bei Patienten mit einer Fehlbildung des Zentralnervensystems, die im Rahmen der pränatalen Diagnostik entdeckt wird
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Autoren
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D. Class
- Klinik für Neurochirurgie der Universität Magdeburg
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S. Pötzsch
- Fehlbildungsmonitoring Sachsen-Anhalt an der Medizinischen Fakultät, Magdeburg
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C. Gerloff
- Klinik für Frauenheilkunde und Geburtshilfe der Universität Magdeburg
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S.-D. Costa
- Klinik für Frauenheilkunde und Geburtshilfe der Universität Magdeburg
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R. Firsching
- Klinik für Neurochirurgie der Universität Magdeburg
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Practice of prenatal screening and counselling of families expecting a child with CNS malformation in Saxony-Anhalt are reviewed as to prevalence rates, prenatal consultations and surgical implications after birth.
Methods: Between 2000 and November 2007 the data of 72 children with CNS malformations detected during prenatal screening in the department of gynaecology and obstetrics were reviewed. They were compared to those of the congenital malformation center. Rates of continuation vs. termination of pregnancy were analysed as well as practical aspects of neurosurgical treatment with special focus on neural tube defects.
Results: Among the group of 72 children we identified 30 with isolated hydrocephalus, 20 children with spina bifida, 10 with anencephalus, 9 with encephalocele and 3 with holoprosencephalia. Abortion was performed in all cases of encephalocele, anencephalus and holo-prosencephalia, in 80% of spina bifida and 23% of isolated hydrocephalus. 10 children with neural tube defects were operated on, 9 with myelodysplasia and 1 with encephalocele.
Conclusions: Prenatal screening allows for early identification of malformations of the CNS and planning for the perinatal period. On the other hand we face an increasing frequency of abortion. As some of the lesions of the aborted children may be surgically treated with good results as shown in long-term follow-up studies a good communication of neurosurgeons is essential with those who advise abortion.
