CONSEQUENCES OF PRENATAL ULTRASOUND DIAGNOSIS - A PRELIMINARY-REPORT ON NEONATES WITH CONGENITAL-MALFORMATIONS

Objective. The aim of the present study was to examine the sensitivity of prenatal ultrasound diagnosis in neonates referred for surgery, an d to test whether a prenatal versus postnatal diagnosis influenced mod e of delivery and neonatal outcome of these infants. Patients. Thirty- six consecutive neonates with congenital diaphragmatic hernia, abdomin al wall defects, bladder exstrophy and meningomyelocele were included. Results. The sensitivity of prenatal ultrasound for diagnosis of the congenital malformations was 7/36 (19%) at 17-18th week of gestation, and overall 13/36 (36%). Overall sensitivity was 2/8 in neonates with congenital diaphragmatic hernia, 6/12 in neonates with abdominal wall defects, 5/13 in neonates with meningomyelocele, whereas none of three cases with bladder exstrophy were detected prenatally. No significant improvement in neonatal morbidity was found comparing the prenatally and postnatally diagnosed groups. The neonatal survival rate was 10/13 (77%) in the prenatally diagnosed group and 22/23 (96%) in the postna tally diagnosed group (p=0.12). Conclusions. The sensitivity of prenat al ultrasound in diagnosing the congenital malformations under study i n a low risk population was 19% at 17-18th week of gestation and 36% t hroughout the pregnancy Prenatal diagnosis altered management of labor , but caused no improvement in neonatal outcome.