Stott, D;
Dos Santos, F;
Rodgers, A;
Holgado, E;
Pandya, PP;
(2022)
Antenatal findings and early postnatal outcomes in pregnancies with trisomy 21: a 10 year retrospective review at a tertiary centre.
Prenatal Diagnosis
, 42
(10)
pp. 1273-1280.
10.1002/pd.6215.
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Abstract
OBJECTIVE: To examine the antenatal imaging features, intrapartum findings and early postpartum course of pregnancies with trisomy 21 (T21) at a tertiary hospital in the United Kingdom. METHODS: Women with pregnancies diagnosed with T21 on antenatal or post-mortem/postnatal karyotyping, from February 2010–2020. Outcome measures included antenatal imaging findings, fetal growth restriction (FGR), birthweight, mode of delivery and early neonatal outcomes. RESULTS: 76 women were included. There were six intrauterine deaths and 70 livebirths. Thirty-eight (50%) had an antenatal diagnosis and twenty-five (33%) had a suspected diagnosis but declined further testing. The diagnosis was unanticipated in 13 (17%). Cardiac anomalies (35.5%) were the most common antenatal anomaly. Doppler abnormalities were apparent in 48/73 (68%). Eighteen (25.7%) had antenatal FGR. The majority were delivered by Caesarean section, and 21.4% of babies weighed <third percentile at delivery. Fifty-eight (82%) were admitted to the neonatal unit. Forty-three (61%) required respiratory support and fifty-five (78%) needed naso-gastric feeding or were nil by mouth. Mean PAPP-A values were significantly lower in cases with abnormal Dopplers, FGR, congenital anomalies and birthweight <10th percentile. CONCLUSIONS: T21 fetuses have high rates of placental insufficiency, FGR and Doppler abnormalities. Postnatally, most require respiratory and feeding support. Antenatal counselling should reflect these risks.
| Type: | Article |
|---|---|
| Title: | Antenatal findings and early postnatal outcomes in pregnancies with trisomy 21: a 10 year retrospective review at a tertiary centre |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/pd.6215 |
| Publisher version: | https://doi.org/10.1002/pd.6215 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Birth Weight, Cesarean Section, Down Syndrome, Female, Fetal Growth Retardation, Humans, Infant, Newborn, Placenta, Pregnancy, Pregnancy-Associated Plasma Protein-A, Retrospective Studies, Trisomy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10159966 |
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