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, 張博文, 等. 國內外多學科團隊診療模式研究進展. 中國醫院, 2022, 26(3): 18-21.
4.	孫湛, 楊麗, 邵雨婷, 等. 多學科診療模式現狀分析與思考. 中國衛生質量管理, 2018, 25(6): 37-40.
5.	王睿敏, 巫洪瑩. 胎兒醫學多學科診療(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.	黨少農, 顏虹, 王紅麗. 出生缺陷的流行態勢和影響因素及人群研究的若干問題. 西安交通大學學報(醫學版), 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.	張春妤, 魏瑗. 胎兒側腦室增寬的診斷和處理. 實用婦產科雜志, 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. 多學科會診在胎兒超聲篩查異常中的診斷價值分析. 當代醫學, 2022, 28(14): 38-41.
18.	沈淳, 莊于修, 顧蔚蓉, 等. 產前多學科會診模式對胎兒結構畸形診治的價值. 中華圍產醫學雜志, 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”重點專項——高齡產婦妊娠期并發癥防治策略研究項目組. 輔助生殖技術助孕雙胎妊娠臨床管理建議. 中國實用婦科與產科雜志, 2021, 37(7): 724-730.
22.	吳怡, 王彥林, 韓旭, 等. 胎兒畸形與染色體異常的關系. 中國實用婦科與產科雜志, 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, 劉喆. 胎兒心臟結構異常的臨床特點及多學科團隊協作對妊娠決策的影響. 中華婦產科雜志, 2023, 58(5): 326-333.
25.	胡婭萍, 余春姣, 孫國強. 多學科會診模式對 1869 例單胎胎兒畸形妊娠結局的影響分析. 中國優生與遺傳雜志, 2019, 27(3): 336-338.
26.	焦曉杰, 劉侃, 王秋明, 等. 多學科會診 387 例胎兒先天性心臟病的臨床結局分析. 國際婦產科學雜志, 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, 張博文, 等. 國內外多學科團隊診療模式研究進展. 中國醫院, 2022, 26(3): 18-21.
4. 孫湛, 楊麗, 邵雨婷, 等. 多學科診療模式現狀分析與思考. 中國衛生質量管理, 2018, 25(6): 37-40.
5. 王睿敏, 巫洪瑩. 胎兒醫學多學科診療(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. 黨少農, 顏虹, 王紅麗. 出生缺陷的流行態勢和影響因素及人群研究的若干問題. 西安交通大學學報(醫學版), 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. 張春妤, 魏瑗. 胎兒側腦室增寬的診斷和處理. 實用婦產科雜志, 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. 多學科會診在胎兒超聲篩查異常中的診斷價值分析. 當代醫學, 2022, 28(14): 38-41.
18. 沈淳, 莊于修, 顧蔚蓉, 等. 產前多學科會診模式對胎兒結構畸形診治的價值. 中華圍產醫學雜志, 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”重點專項——高齡產婦妊娠期并發癥防治策略研究項目組. 輔助生殖技術助孕雙胎妊娠臨床管理建議. 中國實用婦科與產科雜志, 2021, 37(7): 724-730.
22. 吳怡, 王彥林, 韓旭, 等. 胎兒畸形與染色體異常的關系. 中國實用婦科與產科雜志, 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, 劉喆. 胎兒心臟結構異常的臨床特點及多學科團隊協作對妊娠決策的影響. 中華婦產科雜志, 2023, 58(5): 326-333.
25. 胡婭萍, 余春姣, 孫國強. 多學科會診模式對 1869 例單胎胎兒畸形妊娠結局的影響分析. 中國優生與遺傳雜志, 2019, 27(3): 336-338.
26. 焦曉杰, 劉侃, 王秋明, 等. 多學科會診 387 例胎兒先天性心臟病的臨床結局分析. 國際婦產科學雜志, 2022, 49(1): 101-105.

West China Medical Journal

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

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