Efectivitat del cribratge bioquimic de segon trimestre i de l'ecografia de les 20 setmanes en el diagnòstic prenatal de les anomalies cromosòmiques i morfològiques fetals en una població general de gestants

Identifier:  TDX:637

Handle: https://hdl.handle.net/20.500.11797/TDX637

Authors:  Ros Campàs, Narcís

Abstract:
Congenital anomalies are currently the second cause of perinatal and infantile morbidity and mortality in Catalonia.The Catalan Programme of Prenatal Diagnosis of Congenital Anomalies, implemented in 1997, recommends: 1) biochemical screening using the double test (alpha-fetoprotein and β-hCG) to estimate the risks for both trisomy 21(T21) and open neural tube defects (NTD); 2) ultrasound screening by means of the anomaly scan at 20 weeks' gestation and 3) offering an invasive procedure to pregnant women with a high risk for chromosomal anomalies.Objective Evaluate the effectiveness of the Catalan Programme of Prenatal Diagnosis of Congenital Anomalies applied in the Health Plan for 1996-98 in a general population of pregnant women.HypothesisSecond trimester biochemical screening together with the anomaly scan at 20 weeks allow for the prenatal diagnosis of more than 60% of T21 and more than 50 % of detectable structural anomalies.Material and MethodsThis is a prospective cohort including all the fetuses screened by biochemistry or ultrasound in the public health system during a 3-year period.This is a population-based study, in which the study population was formed by the pregnant women attending the 5 health basic areas (ABS) assigned to the Hospital de Sant Pau i Santa Tecla of Tarragona.The fetal anomalies included in the study were all: 1.Clinically relevant chromosomal anomalies, in which termination of pregnancy may be considered as a means of secondary prevention to improve the perinatal and infantile morbidity and mortality;2.Detectable structural anomalies at the 20 weeks' scan (adopting the EUROCAT classification established by this European network of population-based registries for the epidemiologic surveillance of congenital anomalies)Structural anom