Abstract
BackgroundCongenital anomalies occur in approximately 2% of newborns, resulting in severe medical, physical and social disabilities. Managing clinicians, therefore, require more confidence in their diagnosis and prognostic accuracy before appropriately counselling the parents regarding termination of pregnancy.ObjectiveThe aim of this study was to investigate the role of magnetic resonance imaging (MRI) following the diagnosis of foetal anomalies at a foetomaternal unit of a tertiary South African institution.MethodsEighty-eight pregnant women in their late second/third trimester who underwent both an ultrasound (US) at the foetomaternal unit and foetal MRI at the Radiology Department from 01 July 2013 to 30 September 2019 were included in this clinical study conducted at Steve Biko Academic Hospital.ResultsDespite the high degree of concurrence (73.9%) between both modalities regarding the main diagnoses, MRI provided additional information in 45.5% of patients and changed the diagnosis in 25% of the patients. It further demonstrated superiority in providing diagnostic information in 97% of cases where the US alone was inadequate to counsel parents regarding the termination of pregnancy, and it completely changed the clinical management in 42% of cases.ConclusionIt is clearly evident from this study that foetal MRI is a necessity when termination of pregnancy is being considered following an US conducted by the foetomaternal unit. This allows for a complete foetal assessment and gives the managing clinician sufficient diagnostic confidence to prognosticate the future quality of life of the child.
Highlights
Congenital anomalies are reported in approximately 2% of newborn children often because of an unknown aetiology, resulting in severe medical, physical and social disabilities.[1]
Ultrafast foetal magnetic resonance imaging (MRI) could potentially play a significant role as a new modality in comprehensively diagnosing and prognosticating congenital abnormalities detected at US
Patients were only referred for a foetal MRI scan when the foetomaternal specialists came to a conclusion that US was inadequate for formulating a decision
Summary
Congenital anomalies are reported in approximately 2% of newborn children often because of an unknown aetiology, resulting in severe medical, physical and social disabilities.[1] The Choice of Termination of Pregnancy Act (1996) of South Africa allows for termination of pregnancy after the 20th week, until term essentially, as agreed upon by two medical practitioners for major structural anomalies that would result in poor quality of life.[2] Managing clinicians, require more diagnostic confidence and prognostic accuracy on the anomaly or complex anomalies present before appropriately counselling the parents.[1,3]. Congenital anomalies occur in approximately 2% of newborns, resulting in severe medical, physical and social disabilities. Require more confidence in their diagnosis and prognostic accuracy before appropriately counselling the parents regarding termination of pregnancy
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