Fetal Structural Defects Detected Later in Pregnancy Than Chromosomal Abnormalities

MedicalResearch.com Interview with:
Sarah Horvath, MD
Paula M. Castaño, MD, MPH
Anne R. Davis, MD, MPH

Columbia University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Approximately 3% of pregnant women in the United States will receive a prenatal diagnosis of fetal aneuploidy (such as trisomy 21) or fetal structural abnormality (such as cardiac or CNS malformations). Many of these women will undergo abortion. Advances in screening over the past few decades have allowed earlier diagnosis of aneuploidy, but most structural abnormalities cannot be diagnosed until the anatomy ultrasound at 18-20 weeks gestational age because of fixed patterns of fetal development. Our analysis examines gestational age at time of abortion for these two types of fetal diagnosis from 2004-2014.

Our main finding was that median gestational age at time of abortion for fetal aneuploidy decreased from 19 weeks to 14 weeks. However, over the same 11 year period, median gestational age at time of abortion for fetal structural abnormalities remained unchanged and at or above 20 weeks gestation.

MedicalResearch.com: What should readers take away from your report?

Patients with a fetal diagnosis can face very different treatment scenarios. . The timeframe for detection has shifted significantly earlier for common genetic disorders.

If a woman chooses abortion, earlier procedures are safer, more accessible and less expensive. Unfortunately, the science for screening and diagnosis of structural malformations still occurs on a later timeline. Women getting fetal structural diagnoses will receive them later and have less time for decision-making; state laws that limit abortion at or after 20 weeks gestation further complicate care.

MedicalResearch.com: What recommendations for future research do you have a result of this study?

Response: We must ensure that all women have access to the scientific advances in prenatal diagnosis. It is important to study whether early screening is equally offered and utilized across populations. Research enabling earlier diagnosis of structural malformations, whether through improved ultrasound or novel techniques, must be undertaken.

MedicalResearch.com: Is there anything else you would like to add?

Response: Every pregnancy is unique. Pregnant women and their families should have comprehensive care that includes up to date screening tests and, when needed, access to safe abortion.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Trends in Gestational Age at Time of Surgical Abortion for Fetal Aneuploidy and Structural Abnormalities
Davis, Anne R. et al.
American Journal of Obstetrics & Gynecology , Volume 0 , Issue 0 ,
DOI: http://dx.doi.org/10.1016/j.ajog.2016.10.031

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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