Whats Happening When the Pregnancies Are Not Terminated in Case of Anencephalic Fetuses?

Abstract

Background: To review the obstetric outcomes of pregnancies with anencephalic fetuses when these pregnancies are not terminated and ongoing.

Methods: A retrospective chart review is made of the cases with a prenatal diagnosis of anencephaly and who were opted to continue the pregnancy in 1-year period. The evaluated data included gestational age at diagnosis, gestational age at birth, labor induction rates, cesarean delivery rates, stillbirth, shoulder dystocia rate, antepartum and postpartum hemorrhage.

Results: A total of 28 cases that were selected from 87 cases with the diagnosis of anencephaly are included in the study. The average gestational age at diagnosis was 18 weeks. The average gestational age at birth was 31 weeks (range 23 - 37 weeks). Stillbirths were reported in 32% (9/28). Polyhydramnios developed at six patients and two of them required amniodrainage due to severe polyhydramnios. Vaginal birth was achieved in 67% (19/28) of the patients. Labor induction was applied at total 17 patients and one of them had gone to cesarean section due to failed induction. There were two cases of shoulder dystocia. Nine patients had gone to cesarean delivery. Any other complication was not encountered.

Conclusions: Parents should be counseled in detail about continuation of an anencephalic pregnancy before making their decision. The information about what an anencephalic pregnancy can lead' should be given. The redundant cesarean deliveries, polyhydramnios and associated complications, obstetrical hemorrhage risk should be discussed with patients. It should also be emphasized that these maternal risks are for the sake of a non-life expectant baby.

J Clin Med Res. 2019;11(5):332-336
doi: https://doi.org/10.14740/jocmr3777