Perinatal outcome following suspected fetal abnormality when managed through a fetal management unit

Abstract

Objective: To determine the perinatal outcomes of the first 1057 cases seen at a fetal management unit (FMU).

Methods: Record linkage of FMU data with the Victorian Birth data and the Victorian Births Defects Register (BDR).

Results: Ninety-nine percent of cases were followed up with 811 (77%) linked to the BDR and 202 (22%) linked to the birth data. Almost two-thirds of cases with birth defects (528) were live births surviving 28 days, 52 (6%) were neonatal deaths, 26 (3%) were stillbirths and 205 (25%) were terminations. The birth defects most prevalent were of the heart/circulatory system (31%). Cases that resulted in a termination were significantly more likely to have multiple birth defects [OR 2.43 (95% CI 1.70, 3.48)], a chromosomal birth defect [OR 3.30 (95% CI 1.96, 5.57)], a lethal birth defect [OR 1.32 (95% CI 1.25, 1.38)], or a syndrome [OR 4.81 (95% CI 2.54, 9.11)]. In this setting, 61% of cases of Down syndrome resulted in a live birth.

Conclusion: Over three-quarters of cases referred to the FMU were confirmed with a birth defect and notified to the BDR. Notably, two-thirds of the cases (with or without a birth defect) were live births surviving 28 days.