Prenatal diagnosis of lethal fetal malformation in Irish obstetric practice

The diagnosis of lethal fetal malformation prenatally has profound implicat ions for the pregnancy, the expectant couple and the medical care provided. The aim of this study was to investigate these implications and the medica l factors pertaining to prenatal diagnosis of lethal fetal abnormality in c urrent obstetric practice in Ireland. Data was collected prospectively from all cases of lethal fetal malformation diagnosed at the Fetal Medicine Uni t, University College Hospital Galway from December 1997 to June 1998 inclu sive. Diagnosis was made on the basis of ultrasound findings and invasive p rocedures (amniocentesis and chorionic villus sampling). Thirteen cases of lethal fetal abnormality were diagnosed: Edward's syndrome, Patau's syndrom e, bilateral multicystic renal dysplasia, Potters sequence, hypoplastic lef t heart, anencephaly with craniorrhachischisis, lethal osteogenesis imperfe cta and non-immune hydrops, Intrauterine death occurred in four cases, Four women had preterm complications e.g. preterm premature rupture of membrane s, preterm labour, placental abruption, coagulopathy and severe pre-eclamps ia, Three pregnancies progressed to term, two of which had a vaginal delive ry and one had an elective caesarean section for malpresentation, all of wh ich were early neonatal deaths. Three women chose to travel abroad in order to obtain a termination of pregnancy. Obstetric and neonatal dilemmas in m anagement of lethal fetal malformation are discussed.