Year: 2024
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Fetal aqueductal stenosis (AS) affects approximately 1:10,000 pregnancies. Obstruction of cerebral spinal fluid circulation occurs at the aqueduct of Sylvius, leading to progressive hydrocephalus and macrocephaly, which often necessitates cesarean section (CS). The purpose of this study was to describe maternal outcomes associated with fetal AS. METHODS: This study is conducted through the North American Fetal Therapy Network (NAFTNet). Subjects with a prenatal diagnosis of severe fetal central nervous system ventriculomegaly were recruited and followed longitudinally. Maternal events around the delivery of fetuses with AS were recorded and analyzed. RESULTS: Thirty-seven subjects with fetal AS confirmed by neonatal neuroimaging were analyzed. The average gestational age at delivery was 36.7 weeks. Overall, 86% were delivered by CS, and 62% of these were elective. Ninety-one percent of CSs were performed through a Pfannenstiel abdominal incision. A classical uterine incision was required in 13% of cesarean deliveries. The peripartum complication rate was 27%. CONCLUSION: Women carrying a fetus with AS were at risk for preterm birth, cesarean delivery, a classical uterine incision, and peripartum complications. These data highlight the maternal morbidity associated with fetal AS and the potential benefit of in utero therapy not only for neonatal outcomes but also for maternal outcomes.
Source: Fetal Diagnosis and Therapy
DOI: 10.1159/000540196
Institutions: University of Pittsburgh, Magee-Womens Hospital, University of Pittsburgh Medical Center, University of Rochester, Children's Hospital of Wisconsin, Medical College of Wisconsin, Johns Hopkins University, Johns Hopkins Hospital, University of Michigan, Michigan Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Children's Hospital Colorado, University of Colorado Anschutz, Memorial Hermann, University of California Davis Medical Center, University of California, Davis, Children's Minnesota, Stanford Medicine, Stanford University, University of Maryland Medical Center, Riley Hospital for Children, Indiana University School of Medicine
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G2255710957, G3297378414
OpenAlex ID: W4400517806