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Créée le : 16 Jan 2004
Modifiée le : 01 Dec 2007

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Notice bibliographique (sans auteurs) :

Autopsy after termination of pregnancy for fetal anomaly: retrospective cohort study. The British Medical Journal 2004;328:137.

Auteur·e(s) :

Boyd PA, Tondi F, Hicks NR, Chamberlain PF.

Année de publication :

2004

URL(s) :

http://bmj.bmjjournals.com/cgi/content/full/328/74…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To study trends in termination of pregnancy for fetal anomaly over 10 years and to assess the contribution of autopsy to the final diagnosis and counselling after termination.

DESIGN : Retrospective study with cases from a congenital anomaly register and a defined unselected population.

DATA SOURCES : Pregnancies resulting in termination for fetal anomaly identified from the Oxford congenital anomaly register. Details about the prenatal diagnosis and autopsy findings were retrieved from case notes.

RESULTS : Of the 57 258 deliveries, 309 (0.5%) were terminated because of prenatally diagnosed abnormality. There were 129/29 086 (0.4%) terminations for fetal anomaly carried out in 1991-5 and 180/28 172 (0.6%) in 1996-2000. The percentage of fetuses that underwent autopsy fell from 84% to 67%. Autopsy was performed in 132 cases identified by ultrasound scan, with no evidence for abnormal karyotype. In 95 (72%) the autopsy confirmed the suspected diagnosis and did not add important further information, two cases were not classified, and in 35 (27%) the autopsy added information that led to a refinement of the risk of recurrence (reduced in 17, increased in 18); in 11 of these 18 cases it was increased to a one in four risk.

CONCLUSIONS : Though there has been an increase in the rate of terminations of pregnancy for fetal anomaly, there has been a decline in the autopsy rate. When a prenatal diagnosis was based on the results of a scan only, the addition of information from an autopsy by a specialist paediatric pathologist provided important information that changed the estimated risk of recurrence in 27% of cases and in 8% this was to a higher (one in four) risk.

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Mots-clés :

➡ médecine factuelle ; dépistage ; développement du fœtus ; échographie

Auteur·e de cette fiche :

Cécile Loup — 16 Jan 2004