Premium
An audit of invasive prenatal diagnosis for Bart's hydrops
Author(s) -
Tan T. Y. T.,
Yeo G. S. H.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.abs21-5.x
Subject(s) - medicine , hydrops fetalis , prenatal diagnosis , chorionic villus sampling , obstetrics , pediatrics , pregnancy , retrospective cohort study , fetus , gynecology , surgery , genetics , biology
Objective: To audit invasive prenatal diagnosis performed for pregnancies at risk of Bart's hydrops fetalis in KK hospital. Methodology: This is a retrospective study in a single tertiary center in Singapore. All cases of invasive prenatal diagnosis performed for parents whose pregnancies are at risk of Bart's hydrops fetalis between 16 September 1993–28 November 2000 were traced from the KK invasive procedures register. Results: A total of 63 invasive prenatal procedures were done (59 chorionic villus sampling and four cordocentesis) for a total of 44 couples. The majority of the carriers had SEA deletions (84 or 95.5%); Thai deletions (2), compound beta and SEA alpha thalassaemia‐1 traits (1), and HbH disease (1) accounted for the rest. The number of invasive prenatal procedures has increased steadily through the years from 3 in 1994 to 13 in 2000. The major indications for the invasive procedures were past history of Bart's hydrops (30) and both parents being known alpha thalassaemia carriers (27). Both parents were identified as carriers at ≤12 weeks in the 1st pregnancy in 12 couples (27.3%), beyond that time but before the development of hydrops in any pregnancies in 13 couples (29.5%), and after the development of hydrops in 19 couples (43.2%). Eighteen Bart's hydrops were diagnosed and most of them were terminated, either by vacuum aspiration within the first 14 weeks (8) or by prostaglandins beyond the first trimester (8). The iatrogenic fetal loss rate for the invasive procedures was 0% in this audit. Conclusion: Further measures are necessary to increase the proportion of at‐risk couples who are identified as carriers before the first trimester in the first pregnancy to allow early and safe prenatal diagnosis and early terminations of affected pregnancies.