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Antenatal screening and fetal intervention
Abstract:Congenital malformations are a common cause of reduced life expectancy and disability and can affect all body systems, thus are relevant to all surgeons. One in 50 children will have a major or significant congenital anomaly at birth. Since the advent of antenatal ultrasound (US) there has been the potential to diagnose many congenital anomalies before birth. This can forewarn parents and clinicians, so that treatment can be started promptly following birth rather than waiting for the baby to become symptomatic. It has also raised the possibility of treatment in utero with the goal of stopping or reversing the pathological effects of the anomaly on the developing tissues, which hopefully will reduce morbidity and mortality once the baby is born and thus improve outcomes. This article focuses on congenital anomalies relevant to surgeons, initially looking at screening and diagnosis and how this may affect treatment and surgery following delivery. The second part will look at some of the interventions that have been tried to treat “surgical” congenital anomalies in utero.
Keywords:antenatal screening  antenatal ultrasound  congenital diaphragmatic hernia  lower urinary tract obstruction  spina bifida
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