Application of prenatal multi-disciplinary team clinics in fetal developmental abnormalities_West China Medical Journal

Authors：

JIN Xue ^1,2 , JIANG Lijuan ¹ , WANG Ziming ³ , GU Xuesai ³ , CHEN Juan ¹ ,  YANG Lei ¹

1. Department of Pediatric, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Maternal and Child-Related Diseases, Ministry of Education, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Information Management, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YANG Lei, Email: changing120@163.com

Keywords：

Multi-disciplinary team; fetal developmental abnormalities; fetal medicine

DOI：

10.7507/1002-0179.202310167

Video：

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Objective To explore the application of multi-disciplinary team (MDT) clinics in fetal developmental abnormalities. Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital, Sichuan University between December 2021 and November 2022. The situation of pregnant women and fetuses was summarized and analyzed. Results There were 19362 registered pregnant women, of which 1125 (5.8%) had abnormal fetal development. Among them, 272 (24.2%) received prenatal MDT clinics diagnosis and treatment. Fetal developmental abnormalities were mainly characterized by structural abnormalities (208 cases, 76.5%), with the top three being central nervous system abnormalities, circulatory system abnormalities, and multiple malformations. There were 202 pregnant women who continue to conceive, and 70 cases had undergone induced labor, with an induced labor rate of 25.7%. The top three main causes of induced abortion were multiple malformations, central nervous system abnormalities, and circulatory system abnormalities. After prenatal MDT clinics diagnosis and treatment, the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected. Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.

Citation： JIN Xue, JIANG Lijuan, WANG Ziming, GU Xuesai, CHEN Juan, YANG Lei. Application of prenatal multi-disciplinary team clinics in fetal developmental abnormalities. West China Medical Journal, 2024, 39(5): 784-787. doi: 10.7507/1002-0179.202310167 Copy

1.	Kang LY, Guo ZR, Shang WJ, et al. Perinatal prevalence of birth defects in the Mainland of China, 2000-2021: a systematic review and meta-analysis. World J Pediatr, 2024: 1-13.
2.	Li Z, Di J. Prevention and control of birth defects in China: achievements and challenges. China CDC Wkly, 2021, 3(37): 771-772.
3.	毛一晴, 康定鼎, 张博文, 等. 国内外多学科团队诊疗模式研究进展. 中国医院, 2022, 26(3): 18-21.
4.	孙湛, 杨丽, 邵雨婷, 等. 多学科诊疗模式现状分析与思考. 中国卫生质量管理, 2018, 25(6): 37-40.
5.	王睿敏, 巫洪莹. 胎儿医学多学科诊疗(MDT)管理模式探索. 大健康, 2022(1): 83-85.
6.	Society for Maternal-Fetal Medicine (SMFM), Fox NS, Monteagudo A, et al. Mild fetal ventriculomegaly: diagnosis, evaluation, and management. Am J Obstet Gynecol, 2018, 219(1): B2-B9.
7.	Correa-de-Araujo R, Yoon SSS. Clinical outcomes in high-risk pregnancies due to advanced maternal age. J Womens Health (Larchmt), 2021, 30(2): 160-167.
8.	Li XY, Hou MJ, Kong XM, et al. The congenital birth defects burden in children younger than 14 years of age, 1990-2019: an age-period-cohort analysis of the global burden of disease study. J Glob Health, 2024, 14: 4012.
9.	党少农, 颜虹, 王红丽. 出生缺陷的流行态势和影响因素及人群研究的若干问题. 西安交通大学学报(医学版), 2017, 38(3): 317-325.
10.	Hou R, Liu C, Li N, et al. Obstetric complications and outcomes of singleton pregnancy with previous caesarean section according to maternal age. Placenta, 2022, 128: 62-68.
11.	Zhang X, Chen L, Wang X, et al. Changes in maternal age and prevalence of congenital anomalies during the enactment of China’s universal two-child policy (2013-2017) in Zhejiang province, China: an observational study. PLoS Med, 2020, 17(2): e1003047.
12.	Jiang L, Chen Y, Wang Q, et al. A Chinese practice guideline of the assisted reproductive technology strategies for women with advanced age. J Evid Based Med, 2019, 12(2): 167-184.
13.	Weitzner O, Barrett J, Murphy KE, et al. National and international guidelines on the management of twin pregnancies: a comparative review. Am J Obstet Gynecol, 2023, 229(6): 577-598.
14.	张春妤, 魏瑗. 胎儿侧脑室增宽的诊断和处理. 实用妇产科杂志, 2020, 36(3): 179-183.
15.	Tao H, Wu J, Han Y, et al. Genetic etiology and pregnancy outcomes of fetuses with central nervous system anomalies. Arch Gynecol Obstet, 2023: 1-8.
16.	Maistrellis E, Janiak E, Hammel R, et al. Demographic, clinical, and counseling factors associated with the selection of pregnancy termination method in the second trimester for fetal and pregnancy anomalies. Womens Health Issues, 2019, 29(4): 349-355.
17.	潘琴. 多学科会诊在胎儿超声筛查异常中的诊断价值分析. 当代医学, 2022, 28(14): 38-41.
18.	沈淳, 庄于修, 顾蔚蓉, 等. 产前多学科会诊模式对胎儿结构畸形诊治的价值. 中华围产医学杂志, 2014(12): 817-821.
19.	Hsiao CH, Chen CH, Chang YF, et al. Retrospective analysis of stillbirth and induced termination of pregnancies: factors affecting determination. Taiwan J Obstet Gynecol, 2022, 61(4): 626-629.
20.	Bu J, Jiang P, Cui X, et al. Application values of prenatal screening and non-invasive gene sequencing in fetal birth defects. Pak J Med Sci, 2020, 36(7): 1545-1549.
21.	“生殖健康及重大出生缺陷防控研究”重点专项——高龄产妇妊娠期并发症防治策略研究项目组. 辅助生殖技术助孕双胎妊娠临床管理建议. 中国实用妇科与产科杂志, 2021, 37(7): 724-730.
22.	吴怡, 王彦林, 韩旭, 等. 胎儿畸形与染色体异常的关系. 中国实用妇科与产科杂志, 2013, 29(10): 808-812.
23.	Griffiths PD, Bradburn M, Campbell MJ, et al. MRI in the diagnosis of fetal developmental brain abnormalities: the MERIDIAN diagnostic accuracy study. Health Technol Assess, 2019, 23(49): 1-144.
24.	李樉, 刘喆. 胎儿心脏结构异常的临床特点及多学科团队协作对妊娠决策的影响. 中华妇产科杂志, 2023, 58(5): 326-333.
25.	胡娅萍, 余春姣, 孙国强. 多学科会诊模式对 1869 例单胎胎儿畸形妊娠结局的影响分析. 中国优生与遗传杂志, 2019, 27(3): 336-338.
26.	焦晓杰, 刘侃, 王秋明, 等. 多学科会诊 387 例胎儿先天性心脏病的临床结局分析. 国际妇产科学杂志, 2022, 49(1): 101-105.

1. Kang LY, Guo ZR, Shang WJ, et al. Perinatal prevalence of birth defects in the Mainland of China, 2000-2021: a systematic review and meta-analysis. World J Pediatr, 2024: 1-13.
2. Li Z, Di J. Prevention and control of birth defects in China: achievements and challenges. China CDC Wkly, 2021, 3(37): 771-772.
3. 毛一晴, 康定鼎, 张博文, 等. 国内外多学科团队诊疗模式研究进展. 中国医院, 2022, 26(3): 18-21.
4. 孙湛, 杨丽, 邵雨婷, 等. 多学科诊疗模式现状分析与思考. 中国卫生质量管理, 2018, 25(6): 37-40.
5. 王睿敏, 巫洪莹. 胎儿医学多学科诊疗(MDT)管理模式探索. 大健康, 2022(1): 83-85.
6. Society for Maternal-Fetal Medicine (SMFM), Fox NS, Monteagudo A, et al. Mild fetal ventriculomegaly: diagnosis, evaluation, and management. Am J Obstet Gynecol, 2018, 219(1): B2-B9.
7. Correa-de-Araujo R, Yoon SSS. Clinical outcomes in high-risk pregnancies due to advanced maternal age. J Womens Health (Larchmt), 2021, 30(2): 160-167.
8. Li XY, Hou MJ, Kong XM, et al. The congenital birth defects burden in children younger than 14 years of age, 1990-2019: an age-period-cohort analysis of the global burden of disease study. J Glob Health, 2024, 14: 4012.
9. 党少农, 颜虹, 王红丽. 出生缺陷的流行态势和影响因素及人群研究的若干问题. 西安交通大学学报(医学版), 2017, 38(3): 317-325.
10. Hou R, Liu C, Li N, et al. Obstetric complications and outcomes of singleton pregnancy with previous caesarean section according to maternal age. Placenta, 2022, 128: 62-68.
11. Zhang X, Chen L, Wang X, et al. Changes in maternal age and prevalence of congenital anomalies during the enactment of China’s universal two-child policy (2013-2017) in Zhejiang province, China: an observational study. PLoS Med, 2020, 17(2): e1003047.
12. Jiang L, Chen Y, Wang Q, et al. A Chinese practice guideline of the assisted reproductive technology strategies for women with advanced age. J Evid Based Med, 2019, 12(2): 167-184.
13. Weitzner O, Barrett J, Murphy KE, et al. National and international guidelines on the management of twin pregnancies: a comparative review. Am J Obstet Gynecol, 2023, 229(6): 577-598.
14. 张春妤, 魏瑗. 胎儿侧脑室增宽的诊断和处理. 实用妇产科杂志, 2020, 36(3): 179-183.
15. Tao H, Wu J, Han Y, et al. Genetic etiology and pregnancy outcomes of fetuses with central nervous system anomalies. Arch Gynecol Obstet, 2023: 1-8.
16. Maistrellis E, Janiak E, Hammel R, et al. Demographic, clinical, and counseling factors associated with the selection of pregnancy termination method in the second trimester for fetal and pregnancy anomalies. Womens Health Issues, 2019, 29(4): 349-355.
17. 潘琴. 多学科会诊在胎儿超声筛查异常中的诊断价值分析. 当代医学, 2022, 28(14): 38-41.
18. 沈淳, 庄于修, 顾蔚蓉, 等. 产前多学科会诊模式对胎儿结构畸形诊治的价值. 中华围产医学杂志, 2014(12): 817-821.
19. Hsiao CH, Chen CH, Chang YF, et al. Retrospective analysis of stillbirth and induced termination of pregnancies: factors affecting determination. Taiwan J Obstet Gynecol, 2022, 61(4): 626-629.
20. Bu J, Jiang P, Cui X, et al. Application values of prenatal screening and non-invasive gene sequencing in fetal birth defects. Pak J Med Sci, 2020, 36(7): 1545-1549.
21. “生殖健康及重大出生缺陷防控研究”重点专项——高龄产妇妊娠期并发症防治策略研究项目组. 辅助生殖技术助孕双胎妊娠临床管理建议. 中国实用妇科与产科杂志, 2021, 37(7): 724-730.
22. 吴怡, 王彦林, 韩旭, 等. 胎儿畸形与染色体异常的关系. 中国实用妇科与产科杂志, 2013, 29(10): 808-812.
23. Griffiths PD, Bradburn M, Campbell MJ, et al. MRI in the diagnosis of fetal developmental brain abnormalities: the MERIDIAN diagnostic accuracy study. Health Technol Assess, 2019, 23(49): 1-144.
24. 李樉, 刘喆. 胎儿心脏结构异常的临床特点及多学科团队协作对妊娠决策的影响. 中华妇产科杂志, 2023, 58(5): 326-333.
25. 胡娅萍, 余春姣, 孙国强. 多学科会诊模式对 1869 例单胎胎儿畸形妊娠结局的影响分析. 中国优生与遗传杂志, 2019, 27(3): 336-338.
26. 焦晓杰, 刘侃, 王秋明, 等. 多学科会诊 387 例胎儿先天性心脏病的临床结局分析. 国际妇产科学杂志, 2022, 49(1): 101-105.

West China Medical Journal

Application of prenatal multi-disciplinary team clinics in fetal developmental abnormalities

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