Vedran stefanovic mmc_and_other_ntd_finland

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1. Vedran Stefanovic Helsinki University Hospital- Finland NTDs in Finland and the status of preconceptional folic acid supplementation guidelines Vedran Stefanovic…
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  • 1. Vedran Stefanovic Helsinki University Hospital- Finland NTDs in Finland and the status of preconceptional folic acid supplementation guidelines Vedran Stefanovic Fetomaternal Medical Center Helsinki University Hospital- Finland Vedran.stefanovic@hus.fi
  • 2. Prevalence 2.3/ 10 000 births Prevalence steady within last few decades
  • 3. 15.4.2015 Proportion of TOPs (%) of all NTD-pregnancies 1981–2009. TOPs / (births + TOPs) 15.4.2015 Annukka Ritvanen / THL 4 0 20 40 60 80 100 1981 1985 1989 1993 1997 2001 2005 2009 SB ANENCEPHALY
  • 4. Preconceptional/periconceptional FA recommendations in Finland Out-of-date already at the time of publication !!
  • 5. Preconceptional/periconceptional FA recommendations in Finland
  • 6. New guidelines to be published before summer 2015 Low-risk women included Intermediate-risk group still not well-defined
  • 7. Questions (Eleonor) • Can we improve prenatal detection rates? • Can we improve prenatal work up/management? • Do the parents get adequate prenatal counseling? • How can we guarantee equal access to prenatal diagnosis, care and counseling in every region/country? • Why is the abortion rate of prenatally dx MMC so high? • How should we counsel eligible patients about the option of fetal surgery for MMC? •How do we follow-up patients that have underwent fetal surgery for MMC (mother and child)?
  • 8. Improve primary prevention first !!!! Improving DR Exact, professional and centralized counselling for MMC pregnancies Survey on MMC TOPs Improve contact with Fetal Medicine Centres performing MMC fetal surgery Contact with the National Insurance Agencies
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