999 The Incidence of Foetal Scoliosis and the Chances of Successful Delivery

Abstract

Abstract Aim Foetal scoliosis can be detected on antenatal ultrasound and may be associated with other spinal abnormalities such as hemivertebrae. Little is known regarding its incidence and implications. Method The computerised foetal medicine ultrasound database at a tertiary hospital was retrospectively analysed using the search terms “spine” and “scoliosis”, between 1997 and 2021. The reports were manually reviewed, and patients removed that showed no abnormalities. Demographics of the mother, pregnancy and outcome data were collated. Results During the 24-year study period, 600,000 antenatal ultrasound scans were available. A duplicate rate was calculated, resulting in a total population of 378,000 foetuses. Initial results yielded 195 scans, and after removal of duplicates and manual checking of reports, there were 123 cases of confirmed spinal deformities, with an incidence of approximately 0.33 per 1000 foetuses (1 in 3000). Of the 123, there were 59 (48%) that reached term and 64 (52%) which did not. Of those that survived to term, 36/59 (61%) had normal development and no other concerns. The remaining patients had other non-fatal abnormalities, including VACTERL association in 5 cases (8.4%). Of those that did not survive, only one patient did not have other significant abnormalities. In most cases, there were multiple significant abnormalities, and the decision was taken for termination of pregnancy (52 cases, 81%). Conclusions This study represents the largest database review of antenatal scans for spinal abnormalities. The incidence of foetal spinal deformity is approximately 1 in 3000, and prognosis is generally determined by the presence of other significant abnormalities.