دانلود رایگان مقاله انگلیسی سونوگرافی در تشخیص پیش از تولد و تاثیر آن بر اپیدمیولوژی مهره‌شکاف در یک گروه ملی - هینداوی 2018

The aim of this study was to assess the incidence, the prenatal detection rate by ultrasound, and the pregnancy outcome of spina bifida (SB) in Denmark (DK) in 2008–2015 and to compare results to national data from Sweden. Methods. Data were retrieved from the Danish Fetal Medicine Database, which includes International Classification of Diseases- (ICD-) 10 codes for pre- or postnatally diagnoses and pregnancy outcome. Missing data were obtained from the National Patient Register. Livebirth data with myelomeningocele (MMC) in Sweden were obtained from different databases. Results. There were 234 cases with SB in DK in 2008–2015.The incidence of SB was 4.9 : 10,000; 89% were detected with ultrasound prior to week 22; 90% of these pregnancies were terminated (ToP); 91% were isolated malformations of which 11% showed abnormal karyotype. The incidence of newborns with MMC was 1.3 : 10,000 in Sweden. Conclusions. Ultrasound screening has a major impact on the epidemiology of SB. The prenatal detection rate of SB was high, and most SB cases were isolated and had a normal karyotype. Among women with a prenatal fetal diagnosis of SB, 90% chose to have ToP. The incidence of newborns with SB was higher in Sweden than in DK.

5. Conclusion

This study includes all fetal SB cases in Denmark during the years 2008–2015. The study shows that, by using ultrasound screening, almost all cases of a SB can be detected. In a country like Denmark where ToP is regulated by law, prenatal ultrasound screening may have an impact on the number of live births of children with ultrasound-detectable malformations, and it may inform healthcare professional and parental decisions with regard to ToP and the planning of postnatal care for the newborn. The difference between Denmark and Sweden, where acceptance of prenatal ultrasound screening is lower, underlines the effect of a nationwide screening program on the epidemiology of SB.