Obstetricians' agreement on fetal prognosis after ultrasound diagnosis of fetal anomalies

Prenatal Diagnosis
Hilmar H BijmaJuriy W Wladimiroff

Abstract

After ultrasound diagnosis of a severe fetal anomaly is made, difficult decisions may arise regarding obstetric management. Guidelines have been developed to support obstetricians in decision-making. However, it is unknown to what extent in the clinical situation, guidelines are actually supportive. We aimed at: (1) determining whether obstetricians in the presence of a fetal anomaly are able to classify fetal prognosis according to guidelines; (2) establishing inter- and intra-observer agreement regarding fetal prognosis. We used three categories of fetal prognosis: category 1: the infant has no chance of survival and the abnormalities cannot be treated (1.1); or the infant has a chance of extra-uterine survival but post-natal use of life-prolonging medical treatment is considered futile (1.2); category 2: the infant has a chance of extra-uterine survival and post-natal use of life-prolonging medical treatment, if necessary, is considered beneficial. Five senior obstetricians categorized 100 case descriptions of severe fetal abnormalities, which were classified again after five months. Four obstetricians were able to classify 98% or more of cases. In 67% of cases, four or all obstetricians agreed on fetal prognosis. The overal...Continue Reading

Citations

Feb 22, 2012·American Journal of Obstetrics and Gynecology·Stephen D BrownKaren Donelan
May 1, 2012·American Journal of Obstetrics and Gynecology·Britton D Rink
Mar 28, 2018·Qualitative Health Research·Mabel L S LieUNKNOWN MERIDIAN Collaborative Group
Dec 28, 2006·Prenatal Diagnosis·Hilmar H BijmaJuriy W Wladimiroff
Nov 20, 2018·Sociology of Health & Illness·Mabel LiePaul D Griffiths
Apr 14, 2005·Prenatal Diagnosis

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