Impact of prenatal screening and diagnosis on the epidemiology of structural XXXX .

@entity1 @entity154 @entity8 @entity16490 @entity6675
OBJECTIVE: To assess the impact of prenatal screening on the birth prevalence of three categories of @entity154 : abdominal wall defects (omphalocele and @entity6675 ), @entity8 / @entity16490 , and limb reduction defects. SETTING: Glasgow, Scotland, United Kingdom. METHODS: Data on the selected defects were obtained retrospectively from the population based Glasgow Register of @entity154 for the period 1980-91 inclusive. The register records all clinical or laboratory diagnoses of @entity154 in live births, stillbirths, and induced abortions occurring in @entity1 resident within the boundaries of the Greater Glasgow Health Board. The secular trends in the proportions of the defects diagnosed prenatally and terminated after screening, and in their prevalence at birth and during pregnancy, were examined. A total of 154,845 births were surveyed: 309 cases were identified in the selected anomaly categories. RESULTS: 83 cases of omphalocele/ @entity6675 (5.4/10,000 births), 92 cases of @entity8 / @entity16490 (5.9/10,000 births), and 134 cases of limb reduction defects (8.7/10,000 births) were found. Marked increases occurred over the study period in the proportions of cases diagnosed prenatally but not in the proportions terminated. The greatest difference between the prevalence at birth and during pregnancy was found for omphalocele. There were no significant secular trends in the prevalence of the selected defects. CONCLUSIONS: Prenatal screening has made a limited epidemiological impact on the prevalence of these defects. It has been moderately (but inconsistently) effective in the avoidance of births of @entity1 with omphalocele/ @entity6675 and @entity8 / @entity16490 but not of limb reduction defects. Future efforts should be directed towards improving the technical aspects of the ultrasonographic detection of fetal abnormalities and exploring in detail, locally, the reasons for the varying pattern of decision making about termination of pregnancy among prospective parents.
