Fetal Skull Defects – the Best Method of Delivery

Neural tube defects (NTDs) are birth defects of the central nervous system that originate during embryonic development when the neural tube fails to close completely. They are the second most frequent category of congenital anomalies, after congenital heart disease. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. Recent developments in medicine have improved prenatal diagnosis, so that NTDs are diagnosed earlier and the diagnosis is more certain. In Poland, many fetuses with neural tube defects will continue to be delivered, as termination is unacceptable to many. As such, the question to be asked is the following– what is the best method of delivery in these situations. In our study, we analysed courses of pregnancies and methods of delivery of children with NTDs and we compared them with data from literature. The study was conducted in patients from the II Department of Obstetrics and Gynaecology, Medical University in Warsaw, Poland. The purpose of this analysis was to evaluate the advantages and disadvantages of vaginal deliveries compares to C- section. All analysed cases from our Department ended up with vaginal delivery. Careful analysis of these case reports and available literature, suggested, that there are no significant contraindications to vaginal birth for the pregnancies complicated by NTDs. Vaginal delivery of children with lethal defects is save and beneficial for the mother. It has less negative consequences for the women and her future reproduction health.

Joanna Szczepanska, Stefania Kaminska, Anna Stepien, Weronika Woronczuk, Joanna Kacperczyk-Bartnik, Nikola Nieweglowska, Agnieszka Dobrowolska-Redo, Ewa Romejko-Wolniewicz

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