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Prenatal diagnosis and fetal therapy
11st Department of Obstetrics and Gynecology, University of Milano, Italy.
Current Opinion in Obstetrics & Gynecology
|February 1, 1993
Summary
Folic acid supplementation protects against neural tube defects. Prenatal diagnosis advances include noninvasive screening for Down syndrome and evaluating fetal renal damage, improving high-risk patient selection.
Area of Science:
- Obstetrics and Gynecology
- Prenatal Diagnosis
- Fetal Medicine
Background:
- Neural tube defects pose significant risks to newborns.
- Down syndrome screening has historically relied on invasive methods.
- Prenatal diagnosis aims to identify fetal abnormalities for timely intervention.
Purpose of the Study:
- To review advances in prenatal diagnosis.
- To highlight the shift towards noninvasive screening methods.
- To discuss future directions in managing fetal conditions.
Main Methods:
- Review of randomized controlled trials for folic acid supplementation.
- Analysis of large-scale studies on combined maternal and biochemical markers for Down syndrome screening.
- Evaluation of biochemical markers for fetal renal damage assessment.
Main Results:
- Folic acid supplementation significantly reduces neural tube defect risk.
- Second-trimester screening for Down syndrome using maternal and biochemical markers is feasible and effective.
- Urinary biochemistry analysis shows promise for selecting fetuses with obstructive uropathy for antenatal treatment.
Conclusions:
- Noninvasive prenatal testing is increasingly important for selecting high-risk pregnancies.
- Safety concerns have reduced the emphasis on early invasive procedures like chorionic villus sampling and amniocentesis.
- Further research is needed for conditions like twin-to-twin transfusion syndrome.