Antenatal Diagnosis of Fetal Abnormalities by N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian PDF


By N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian Donnai MBBS, FRCP, DCH, DObst, RCOG (eds.)

In few parts of medication is growth extra remarkable than within the box of prenatal prognosis. New scientific suggestions equivalent to chorion villus sampling, exact ultrasound scanning and cordocentesis are being evaluated via obstetricians, and refinement of biochemical checking out is widening the scope of maternal serum screening. within the laboratory, dramatic advances in molecular biology are happening: households liable to genetic affliction will be investigated with gene probes, and preimplantation prognosis of the embryo is now becom­ ing a truth. those technical advances have vital moral and sensible implications, between to be able to be yet another elevate in public expectancies of the criteria required of antenatal companies. Clini­ cians will want a excessive measure of ability to notify fit girls in regards to the thoughts for screening basic pregnancies, and to tips high-risk girls concerning the advantages and obstacles of prenatal analysis. Obstetricians, scientists and well-being carrier managers will face the tough activity of determining how prenatal analysis will be made to be had to ladies in a worrying and economical approach. Recognising the speedy development during this box, the Royal university of Obstetricians and Gynaecologists made prenatal analysis the topic of its twenty third examine crew. a world panel of best researchers, whose services ranged from molecular biology to philosophy, was once invited to take part in a 3 day workshop, with time for in-depth dialogue in addition to the presentation of papers.

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Abramowicz JS, Warsof SL, Doyle DL, Smith D, Levy DL. Congenital cystic hygroma of the neck diagnosed prenatally: outcome with normal and abnormal karyotype. Prenat Diagn 1989; 9:321-7. 6. Helin I, Persson PH. Prenatal diagnosis of urinary tract abnormalities by ultrasound. Pediatrics 1986; 78:879-83. 7. Livera LN, Bookfield DSK, Egginton JA, Hawnaur JM. Antenatal ultrasonography to detect fetal renal abnormalities: a prospective screening programme. Br Med J 1989; 298:1421-3. 8. Van de Hof MC, Nicolaides KH, Campbell J, Campbell S.

One of the problems, and it comes back to the question about OPCS, is that they have no mechanism for validating what is put into them, and this is particularly important in areas of genitourinary (GU) anomalies. Wald: I believe there is some concern that there is an increased prevalence of undescended testicle that has also been linked to increases in the rate of testicular cancer later in life. There is speCUlation as to whether this is real and whether there might be some causal factor. Nevin: Many of the systems for monitoring defects may not include what they call minor anomalies, such as undescended testicle, inguinal hernia, or epispadias.

Second, anencephaly showed the most profound fall and the earliest fall. Anencephaly is quite obvious on ultrasound screening and is more easily diagnosed with ex-fetoprotein (AFP) screening, and as there is no register of terminations I suspect perhaps some of the patients from Northern Ireland will have come over to the mainland for their terminations of pregnancy. With these points in mind, can Professor Nevin reassure me that there is a true fall in prevalence, not reflecting prenatal diagnosis?

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