Mark Paul Johnson

Aneuploidy with Neural Tube Defects: Another Reason for Complete Evaluation in Patients with Suspected Ultrasound Anomalies or Elevated Maternal Serum Alpha-Fetoprotein

Some recent reports have suggested that invasive testing is unnecessary when ultrasound either confirms or refutes a neural tube defect (NTD). However, counseling for recurrence risks and the possibilities for in utero therapy would be significantly altered by an aneuploid karyotype. We report our experience with 53 pregnancies affected by NTD in which we found 13.2% of these fetuses with abnormal chromosomes. In view of the higher than previously published incidence of aneuploidy, we believe that fetal karyotypes are essential in the evaluation of all fetuses with NTDs.

Coercion for Fetal Therapy

The “fetus as a patient” has over the past two decades become an accepted concept in obstetrics.1 A specific field of fetal medicine has developed as a recognized subspecialty.2 There are, however, complex interactions that emerge from the alteration of roles and responsibilities that have evolved over the past decade. Maternal-fetal conflicts for standard and experimental indications are likely to abound in the coming decade.3