Prenatal consultation for foetal anomalies requiring surgery

Who needs prenatal counselling with a pediatric surgeon? Experience from a large tertiary care university hospital

OBJECTIVES

To describe our experience with prenatal counselling for surgical anomalies in a large volume center. The secondary aim is to suggest a list of prenatal abnormalities warranting counselling by a pediatric surgeon.

METHODS

We reviewed all prenatal counselling consultations performed by the pediatric surgery team between January 1st, 2015 and December 31st, 2016.

RESULTS

A total of 169 patients or couples had a prenatal consultation with a pediatric surgeon. Prenatal work-up included a fetal MRI in 26% of cases, mainly for digestive and thoracic pathologies (56.1% of cases). Consultation with the pediatric surgeon led mainly to recommendations concerning the place of delivery. Induction for reasons related to the fetal anomaly occurred in 22.2% of cases. Most children were surgically treated within the first year of life (63.5%). Correlation between predicted prognosis and actual status at four years of life was 96.9%. Correlation between prenatal and postnatal diagnosis was 87.4%.

CONCLUSIONS

Prenatal counselling by a pediatric surgeon allows couples to obtain clear information on the pathology of their unborn child, giving them greater autonomy in their decision to continue the pregnancy.

The Prenatal Diagnosis and Consultation for Cleft Lip and Palate Prior to Presurgical Infant Orthopedics and Early Dental Care

Children born with cleft lip and/or cleft palate (CL/P) have unique treatment needs and benefit from a team of health care providers, including surgeons, dentists, and allied health professionals. Presurgical infant orthopedic appliances can reduce the severity of the birth defect and can be provided to patients by a dental health care professional starting at birth. The dental needs of patients with CL/P are multifaceted and having an established dental home to monitor growth and development and help with disease prevention is key to improve oral health.