BENEFITS AND ADVERSE-EFFECTS OF PRENATAL-DIAGNOSIS IN NONUROLOGICAL SURGICAL DISORDERS

The purpose of this study was to assess the accuracy of prenatal ultra sound in correctly diagnosing fetal structural abnormality requiring s urgical intervention and to evaluate its effect on management and even tual outcome. Information was collected from existing departmental dat abases. From 1985 to 199 1, 101 surgical disorders were suspected pren atally in the Yorkshire region; termination of pregnancy was requested in 6. Prenatal diagnoses were incorrect in 22/ 1 0 1, six being norma l infants. In 28/1 01 cases the diagnosis was made after 30 weeks of g estation. Transfer to the tertiary referral centre was postnatal in 12 /95 cases, although prenatal diagnosis should have allowed earlier ref erral. Mortality data for the 95 infants showed a survival of 73 % ove rall. Definite parental anxiety resulting from either an incorrect dia gnosis, inappropriate counselling, or unnecessary investigations was i dentified in 16 cases. Although prenatal diagnosis is helpful in the m ajority of cases, these findings suggest the need for improvements in diagnostic accuracy, inter-departmental communications and patient car e.