Tıbbi Terminasyon Yapılan ve Gestasyonel Yaşı 12-24 Hafta Olan Fetüslerin Prenatal Ultrasonografi ve Postmortem İnceleme Bulgularının Karşılaştırılması

Abstract

By comparing the prenatal USG findings and the autopsy findings of the fetuses who underwent medical termination between 12-24th gestational weeks at Department of Obstetrics and Gynecology at Hacettepe University Faculty of Medicine and were autopsied at the İhsan Doğramacı Children’s Hospital Pediatric and Perinatal Pathology Department, we aimed to emphasize the importance of autopsy at diagnosis, to show that there may be additional findings added by autopsy and which may affect genetic counseling. In our study, a total of 84 cases that were autopsied between 1 June 2015 and 30 June 2019 were analyzed retrospectively. Malformations (n = 36, 42.8%) are the most common in medical termination indications. When autopsy findings are examined, multiple findings in 40 (%25,3) fetuses and other findings (Hydrops fetalis, cystic hygroma, IUGR, facial anomalies) in 32 (%20,2) fetuses are detected, then central nervous system (n=24, %15,2), musculoskeletal system (n=19, %12), pulmonary system (n=13, %8,2), genitourinary (n=11, %7) and gastrointestinal tract (n=11, %7) and cardiovascular system (n=8, %5,1) are following. As additional findings at autopsy, there are 15 (23.4%) findings in the central nervous system, 9 (12.3%) findings in the musculoskeletal system, 5 (45.4%) findings in the genitourinary system, 6 (%) 63,6) findings, 3 (37.5%) findings of the cardiovascular system, 13 (100%) findings of respiratory system and 19 (27.1%) findings of other systems. In addition, there are multiple system anomalies in 13 fetuses (17.7%) in USG, while there are 40 (25.3%) fetuses in autopsy. When USG and autopsy findings were compared, there was a complete concordance in 48 (%57,1) fetuses. In addition to USG findings, the number of fetuses with additional minor autopsy findings is 26 (%31) and the number of fetuses with additional major autopsy findings is 4 (%4,8). In six fetuses (%7,1) autopsy and USG findings were completely discordant. Genetic testing was performed on 57 of fetuses (%67,9) and chromosomal anomaly was detected in 11 (%13,1) fetuses. Today prenatal diagnosis is advanced, but autopsy is needed.