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Does prenatal counseling for pregnancies complicated by multiple fetal abnormalities concord with postnatal outcomes?
Author(s) -
Baker Anna,
Lagatta Joanne,
Leuthner Steven,
Acharya Krishna
Publication year - 2020
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5636
Subject(s) - medicine , concordance , pregnancy , fetus , retrospective cohort study , pediatrics , medical record , cohort , prenatal diagnosis , obstetrics , surgery , genetics , biology
Objective In pregnancies complicated by multiple fetal abnormalities, our objective was to determine the degree of concordance between prenatal prognosis and postnatal outcomes. Method Retrospective cohort study of pregnancies with multiple fetal abnormalities referred to the Fetal Concerns Center of Wisconsin (FCCW) from 2015 to 2018. We reviewed records for anomalies, given prognostic severity, and postnatal outcomes. Prognostic severity was categorized as “likely mortality,” “severe impairment,” “moderate,” and “mild” based on predetermined criteria. Results In 85 pregnancies with multiple fetal abnormalities, 48% were given a prognosis of “likely mortality,” and 19% were given a prognosis of “severe impairment.” In pregnancies that were continued after being counseled as “likely mortality,” this outcome was concordant in all but one case, despite medical interventions. In pregnancies counseled as “severe impairment,” the more common outcome was mortality or severe impairment in 88% of cases and survival with severe impairment in 33% of cases. Postnatal outcomes were concordant with prenatal severity in 68% of the cases, more severe in 20% of the cases, and less severe in fewer than 5% of cases. Conclusion Prenatal predictions about severe outcomes are usually true in pregnancies complicated by multiple abnormalities. In cases of outcome discordance, outcomes tend to be more severe than predicted.