Generic placeholder image

Current Pediatric Reviews


ISSN (Print): 1573-3963
ISSN (Online): 1875-6336

Systematic Review Article

Perinatal Management of Pregnancies with Fetal Congenital Anomalies: A Guide to Obstetricians and Pediatricians

Author(s): Mishu Mangla* and Rajendra Prasad Anne

Volume 20, Issue 2, 2024

Published on: 10 November, 2022

Page: [150 - 165] Pages: 16

DOI: 10.2174/1573396318666221005142001

Price: $65


Background: Congenital anomalies are responsible for approximately 20% of all neonatal deaths worldwide. Improvements in antenatal screening and diagnosis have significantly improved the prenatal detection of birth defects; however, these improvements have not translated into the improved neonatal prognosis of babies born with congenital anomalies.

Objectives: An attempt has been made to summarise the prenatal interventions, if available, the optimal route, mode and time of delivery and discuss the minimum delivery room preparations that should be made if expecting to deliver a fetus with a congenital anomaly.

Methods: The recent literature related to the perinatal management of the fetus with prenatally detected common congenital anomalies was searched in English peer-reviewed journals from the PubMed database to work out an evidence-based approach for their management.

Results: Fetuses with prenatally detected congenital anomalies should be delivered at a tertiary care centre with facilities for neonatal surgery and paediatric intensive care if needed. There is no indication for preterm delivery in the majority of cases. Only a few congenital malformations, like highrisk sacrococcygeal teratoma, congenital lung masses with significant fetal compromise, fetal cerebral lesions or neural tube defects with Head circumference >40 cm or the biparietal diameter is ≥12 cm, gastroschisis with extracorporeal liver, or giant omphaloceles in the fetus warrant caesarean section as the primary mode of delivery.

Conclusion: The prognosis of a fetus with congenital anomalies can be significantly improved if planning for delivery, including the place and time of delivery, is done optimally. A multidisciplinary team should be available for the fetus to optimize conditions right from when it is born.

Keywords: Congenital malformations, route of delivery, time of delivery, optimal mode of delivery, perinatal management, caesarean section or vaginal delivery.

Graphical Abstract
Bhide P, Kar A. A national estimate of the birth prevalence of congenital anomalies in India: systematic review and meta-analysis. BMC Pediatr 2018; 18(1): 175.
[] [PMID: 29801440]
Vayna AM, Veduta A, Duta S, et al. Diagnosis of fetalstructural anomalies at 11 to 14 weeks. J Ultrasound Med 2018; 37(8): 2063-73.
[] [PMID: 29476550]
Arunda M, Emmelin A, Asamoah BO. Effectiveness of antenatal care services in reducing neonatal mortality in Kenya: analysis of national survey data. Glob Health Action 2017; 10(1): 1328796.
[] [PMID: 28621201]
Carta S, Kealin Agten A, Belcaro C, Bhide A. Outcome of fetuses with prenatal diagnosis of isolated severe bilateral ventriculomegaly: Systematic review and meta-analysis. Ultrasound Obstet Gynecol 2018; 52(2): 165-73.
[] [PMID: 29484752]
Dozier JL, Hennink M, Mosley E, et al. Abortion attitudes, religious and moral beliefs, and pastoral care among Protestant religious leaders in Georgia. PLoS One 2020; 15(7): e0235971.
[] [PMID: 32678861]
Wataganara T, Grunebaum A, Chervenak F, Wielgos M. Delivery modes in case of fetal malformations. J Perinat Med 2017; 45(3): 273-9.
[] [PMID: 27071145]
Moldenhauer JS, Adzick NS. Fetal surgery for myelomeningocele: After the Management of Myelomeningocele Study (MOMS). Semin Fetal Neonatal Med 2017; 22(6): 360-6.
[] [PMID: 29031539]
Saadai P, Farmer DL. Fetal surgery for myelomeningocele. Clin Perinatol 2012; 39(2): 279-88.
[] [PMID: 22682379]
Adzick NS, Thom EA, Spong CY, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 2011; 364(11): 993-1004.
[] [PMID: 21306277]
Joyeux L, De Bie F, Danzer E, et al. Learning curves of open and endoscopic fetal spina bifida closure: systematic review and meta‐analysis. Ultrasound Obstet Gynecol 2020; 55(6): 730-9.
[] [PMID: 31273862]
Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Guideline No. 410: Prevention, screening, diagnosis, and pregnancy management for fetal neural tube defects. J Obstet Gynaecol Can 2021; 43(1): 124-139.e8.
[] [PMID: 33212246]
Shurtleff DB, Luthy DA, Nyberg DA, Benedetti TJ, Mack LA. Meningomyelocele: management in utero and post natum. Novartis Found Symp 2007; 181: 270-88.
[] [PMID: 8005029]
Tolcher MC, Shazly SA, Shamshirsaz AA, et al. Neurological outcomes by mode of delivery for fetuses with open neural tube defects: A systematic review and meta-analysis. BJOG 2019; 126(3): 322-7.
[] [PMID: 29924919]
Rendeli C, Nucera E, Ausili E, et al. Latex sensitisation and allergy in children with myelomeningocele. Childs Nerv Syst 2006; 22(1): 28-32.
[] [PMID: 15703967]
Pektaş A, Boyacı MG, Koyuncu H, Pektaş MK, Kundak AA. Timeliness of postnatal surgery in newborns with open neural tube defects: A single center experience. Turk J Pediatr 2021; 63(4): 683-90.
[] [PMID: 34449151]
Huang YS, Lussier EC, Olisova K, Chang YC, Ko H, Chang TY. Prenatal ultrasound diagnosis of neural tube defects in the era of intrauterine repair – Eleven years’ experiences. Taiwan J Obstet Gynecol 2021; 60(2): 281-9.
[] [PMID: 33678328]
Pal NL, Juwarkar AS, Viswamitra S. Encephalocele: know it to deal with it. Egypt J Radiol Nucl Med 2021; 52(1): 105.
Weichert J, Hoellen F, Krapp M, et al. Fetal cephaloceles: prenatal diagnosis and course of pregnancy in 65 consecutive cases. Arch Gynecol Obstet 2017; 296(3): 455-63.
[] [PMID: 28634753]
Cavalheiro S, Silva da Costa MD, Nicácio JM, et al. Fetal surgery for occipital encephalocele. J Neurosurg Pediatr 2020; 26(6): 605-12.
[] [PMID: 32916650]
Markovic I, Bosnjakovic P, Milenkovic Z. Occipital encephalocele: Cause, incidence, neuroimaging and surgical management. Curr Pediatr Rev 2020; 16(3): 200-5.
[] [PMID: 31656152]
Norton ME, Fox NS, Monteagudo A, Kuller JA, Craigo S. Fetal Ventriculomegaly. Am J Obstet Gynecol 2020; 223(6): B30-3.
[] [PMID: 33168210]
McGirt MJ, Leveque JC, Wellons JC III, et al. Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg 2002; 36(5): 248-55.
[] [PMID: 12053043]
Litwinska M, Litwinska E, Czaj M, Polis B, Polis L, Szaflik K. Ventriculo‐amniotic shunting for severe fetal ventriculomegaly. Acta Obstet Gynecol Scand 2019; 98(9): 1172-7.
[] [PMID: 30977122]
Sparey C, Robson S. Fetal cerebral ventriculomegaly. Fetal Matern Med Rev 1998; 10(3): 163-79.
Lipschuetz M, Cohen SM, Israel A, et al. Sonographic large fetal head circumference and risk of cesarean delivery. Am J Obstet Gynecol 2018; 218(3): 339.e1-7.
[] [PMID: 29305249]
Wang KC, Lee JY, Kim SK, Phi JH, Cho BK. Fetal ventriculomegaly: postnatal management. Childs Nerv Syst 2011; 27(10): 1571-3.
[] [PMID: 21928022]
Nagaraj UD, Kline-Fath BM. Imaging diagnosis of ventriculomegaly: fetal, neonatal, and pediatric. Childs Nerv Syst 2020; 36(8): 1669-79.
[] [PMID: 31624860]
Paek BW, Callen PW, Kitterman J, et al. Successful fetal intervention for congenital high airway obstruction syndrome. Fetal Diagn Ther 2002; 17(5): 272-6.
[] [PMID: 12169810]
Ashraf A, Abdelrahman AM, Senna A, Alsaad F. Congenital High Airway Obstruction Syndrome (CHAOS): No intervention, no survival—A case report and literature review. Case Rep Radiol 2020; 2020: 1036073.
[] [PMID: 32685231]
Kumar M, Gupta A, Kumar V, et al. Management of CHAOS by intact cord resuscitation: case report and literature review. J Matern Fetal Neonatal Med 2019; 32(24): 4181-7.
[] [PMID: 29842812]
García-Díaz L, Chimenea A, de Agustín JC, Pavón A, Antiñolo G. Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses. BMC Pregnancy Childbirth 2020; 20(1): 598.
[] [PMID: 33028259]
D’Eufemia MD, Cianci S, Di Meglio F, et al. Congenital high airway obstruction syndrome (CHAOS): discussing the role and limits of prenatal diagnosis starting from a single-center case series. J Prenat Med 2016; 10(1-2): 4-7.
[PMID: 28725339]
Hedrick HL, Crombleholme TM, Flake AW, et al. Right congenital diaphragmatic hernia: prenatal assessment and outcome. J Pediatr Surg 2004; 39(3): 319-23.
[] [PMID: 15017545]
Kashyap A, DeKoninck P, Crossley K, et al. Antenatal medical therapies to improve lung development in congenital diaphragmatic hernia. Am J Perinatol 2018; 35(9): 823-36.
[] [PMID: 29341044]
Logan JW, Rice HE, Goldberg RN, Cotten CM. Congenital diaphragmatic hernia: A systematic review and summary of best-evidence practice strategies. J Perinatol 2007; 27(9): 535-49.
[] [PMID: 17637787]
Danzer E, Gerdes M, D’Agostino JA, et al. Younger gestational age is associated with increased risk of adverse neurodevelopmental outcome during infancy in congenital diaphragmatic hernia. J Pediatr Surg 2016; 51(7): 1084-90.
[] [PMID: 26831532]
Puligandla PS, Skarsgard ED, Offringa M, et al. Diagnosis and management of congenital diaphragmatic hernia: a clinical practice guideline. CMAJ 2018; 190(4): E103-12.
[] [PMID: 29378870]
Kumar VHS. Current concepts in the management of congenital diaphragmatic hernia in infants. Indian J Surg 2015; 77(4): 313-21.
[] [PMID: 26702239]
Snoek KG, Reiss IKM, Greenough A, et al. Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: The CDH EURO Consortium Consensus - 2015 Update. Neonatology 2016; 110(1): 66-74.
[] [PMID: 27077664]
Stallings EB, Isenburg JL, Short TD, et al. Population‐based birth defects data in the United States, 2012–2016: A focus on abdominal wall defects. Birth Defects Res 2019; 111(18): 1436-47.
[] [PMID: 31642616]
Cassina M, Ruol M, Pertile R, et al. Prevalence, characteristics, and survival of children with esophageal atresia: A 32-year population-based study including 1,417,724 consecutive newborns. Birth Defects Res A Clin Mol Teratol 2016; 106(7): 542-8.
[] [PMID: 26931365]
Bradshaw CJ, Thakkar H, Knutzen L, et al. Accuracy of prenatal detection of tracheoesophageal fistula and oesophageal atresia. J Pediatr Surg 2016; 51(8): 1268-72.
[] [PMID: 26932255]
Johansen M, Veyckemans F, Engelhardt T. Congenital anomalies of the large intrathoracic airways. Paediatr Anaesth 2022; 32(2): 126-37.
[] [PMID: 34797930]
Krishnan U, Mousa H, Dall’Oglio L, et al. ESPGHAN-NASPGHAN guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with esophageal atresia-tracheoesophageal fistula. J Pediatr Gastroenterol Nutr 2016; 63(5): 550-70.
[] [PMID: 27579697]
Dingemann C, Eaton S, Aksnes G, et al. ERNICA consensus conference on the management of patients with esophageal atresia and tracheoesophageal fistula: follow-up and framework. Eur J Pediatr Surg 2020; 30(6): 475-82.
[] [PMID: 31777030]
Gornall AS, Budd JLS, Draper ES, Konje JC, Kurinczuk JJ. Congenital cystic adenomatoid malformation: accuracy of prenatal diagnosis, prevalence and outcome in a general population. Prenat Diagn 2003; 23(12): 997-1002.
[] [PMID: 14663837]
Kunisaki SM, Fauza DO, Barnewolt CE, et al. Ex utero intrapartum treatment with placement on extracorporeal membrane oxygenation for fetal thoracic masses. J Pediatr Surg 2007; 42(2): 420-5.
[] [PMID: 17270561]
Crombleholme TM, Coleman B, Hedrick H, et al. Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung. J Pediatr Surg 2002; 37(3): 331-8.
[] [PMID: 11877643]
Adzick NS. Open fetal surgery for life-threatening fetal anomalies. Semin Fetal Neonatal Med 2010; 15(1): 1-8.
[] [PMID: 19540178]
Priest JR, Williams GM, Hill DA, Dehner LP, Jaffé A. Pulmonary cysts in early childhood and the risk of malignancy. Pediatr Pulmonol 2009; 44(1): 14-30.
[] [PMID: 19061226]
Cruz-Martínez R, Gratacós E. Bronchopulmonary sequestration Obstet Imaging Fetal Diagnosis Care. 2nd ed.; Wolters Kluwers: Netherlands 2017; p. 16-19.e1.
Bruner JP, Jarnagin BK, Reinisch L. Percutaneous laser ablation of fetal congenital cystic adenomatoid malformation: too little, too late? Fetal Diagn Ther 2000; 15(6): 359-63.
[] [PMID: 11111218]
Bermúdez C, Pérez-Wulff J, Bufalino G, Sosa C, Gómez L, Quintero RA. Percutaneous ultrasound-guided sclerotherapy for complicated fetal intralobar bronchopulmonary sequestration. Ultrasound Obstet Gynecol 2007; 29(5): 586-9.
[] [PMID: 17444552]
Pock R. Straňák Z, Vojtěch J, Hašlík L, Feyereisl J, Krofta L. Bronchopulmonary sequestration with fetal hydrops in a monochorionic twin successfully treated with multiple courses of betamethasone. AJP Rep 2018; 8(4): e359-61.
[] [PMID: 30574430]
Shamshirsaz AA, Aalipour S, Erfani H, et al. Obstetric outcomes of ex‐utero intrapartum treatment (EXIT). Prenat Diagn 2019; 39(8): 643-6.
[] [PMID: 31093996]
Berman L, Jackson J, Miller K, Kowalski R, Kolm P, Luks FI. Expert surgical consensus for prenatal counseling using the Delphi method. J Pediatr Surg 2018; 53(8): 1592-9.
[] [PMID: 29274787]
David M, Lamas-Pinheiro R, Henriques-Coelho T. Prenatal and postnatal management of congenital pulmonary airway malformation. Neonatology 2016; 110(2): 101-15.
[] [PMID: 27070354]
Corbett HJ, Humphrey GME. Pulmonary sequestration. Paediatr Respir Rev 2004; 5(1): 59-68.
[] [PMID: 15222956]
Forrester MB, Merz RD. Population-based study of small intestinal atresia and stenosis, Hawaii, 1986–2000. Public Health 2004; 118(6): 434-8.
[] [PMID: 15313597]
Choudhry MS, Rahman N, Boyd P, Lakhoo K. Duodenal atresia: associated anomalies, prenatal diagnosis and outcome. Pediatr Surg Int 2009; 25(8): 727-30.
[] [PMID: 19551391]
Stoll C, Alembik Y, Dott B, Roth MP. Evaluation of prenatal diagnosis of congenital gastro-intestinal atresias. Eur J Epidemiol 1996; 12(6): 611-6.
[] [PMID: 8982621]
Hertzberg BS. The fetal gastrointestinal tract. Semin Roentgenol 1998; 33(4): 360-8.
[] [PMID: 9800246]
Rousková B, Trachta J, Kavalcová L, Kuklová P, Kyncl M. Duodenal atresia and stenosis. Cas Lek Cesk 2008; 147(10): 521-6.
[PMID: 19177734]
Sinha S, Sarin YK. Outcome of jejuno-ileal atresia associated with intraoperative finding of volvulus of small bowel. J Neonatal Surg 2012; 1(3): 37.
Ionescu S, Andrei B, Oancea M, et al. Postnatal treatment in antenatally diagnosed meconium peritonitis. Chirurgia (Bucur) 2015; 110(6): 538-44.
[PMID: 26713828]
Norton ME, Cheng Y, Chetty S, et al. SMFM Fetal Anomalies Consult Series #4: Genitourinary anomalies. Am J Obstet Gynecol 2021; 225(5): B2-B35.
[] [PMID: 34507800]
Dukic L, Schaffelder R, Schaible T, Sütterlin M, Siemer J. Massive fetal abdominal girth increase in hereditary cystic kidney disease. Z Geburtshilfe Neonatol 2010; 214(3): 119-22.
[] [PMID: 20574939]
Gabriele MM, Koch Nogueira PC. Management of Hypertension in CAKUT: Protective Factor for CKD. Front Pediatr 2019; 7: 222.
Braga LHP, Ruzhynsky V, Pemberton J, Farrokhyar F, DeMaria J, Lorenzo AJ. Evaluating practice patterns in postnatal management of antenatal hydronephrosis: A national survey of Canadian pediatric urologists and nephrologists. Urology 2014; 83(4): 909-14.
[] [PMID: 24411215]
Sinha A, Bagga A, Krishna A, et al. Revised guidelines on management of antenatal hydronephrosis. Indian J Nephrol 2013; 23(2): 83-97.
[] [PMID: 23716913]
Bhat V, Moront M, Bhandari V. Gastroschisis: A state-of-the-art review. Children (Basel) 2020; 7(12): 302.
Verla MA, Style CC, Olutoye OO. Prenatal diagnosis and management of omphalocele. Semin Pediatr Surg 2019; 28(2): 84-8.
[] [PMID: 31072463]
Barisic I, Clementi M, Häusler M, Gjergja R, Kern J, Stoll C. Evaluation of prenatal ultrasound diagnosis of fetal abdominal wall defects by 19 European registries. Ultrasound Obstet Gynecol 2001; 18(4): 309-16.
[] [PMID: 11778988]
Burge DM, Ade-Ajayi N. Adverse outcome after prenatal diagnosis of gastroschisis: The role of fetal monitoring. J Pediatr Surg 1997; 32(3): 441-4.
[] [PMID: 9094013]
Shamshirsaz AA, Lee TC, Hair AB, et al. Elective delivery at 34 weeks vs routine obstetric care in fetal gastroschisis: randomized controlled trial. Ultrasound Obstet Gynecol 2020; 55(1): 15-9.
[] [PMID: 31503365]
Cain MA, Salemi JL, Paul Tanner J, et al. Perinatal outcomes and hospital costs in gastroschisis based on gestational age at delivery. Obstet Gynecol 2014; 124(3): 543-50.
[] [PMID: 25162254]
Kirollos DW, Abdel-Latif ME. Mode of delivery and outcomes of infants with gastroschisis: a meta-analysis of observational studies. Arch Dis Child Fetal Neonatal Ed 2018; 103(4): F355-63.
[] [PMID: 28970315]
Segel SY, Marder SJ, Parry S, Macones GA. Fetal abdominal wall defects and mode of delivery: a systematic review. Obstet Gynecol 2001; 98(5, Part 1): 867-73.
[] [PMID: 11704185]
How HY, Harris BJ, Pietrantoni M, et al. Is vaginal delivery preferable to elective cesarean delivery in fetuses with a known ventral wall defect? Am J Obstet Gynecol 2000; 182(6): 1527-34.
[] [PMID: 10871475]
Bielicki IN, Somme S, Frongia G, Holland-Cunz SG. Vuille-dit-Bille RN. Abdominal wall defects—current treatments. Children (Basel) 2021; 8(2): 170.
[] [PMID: 33672248]
Storm AP, Bowker RM, Klonoski SC, et al. Mother’s own milk dose is associated with decreased time from initiation of feedings to discharge and length of stay in infants with gastroschisis. J Perinatol 2020; 40(8): 1222-7.
[] [PMID: 31992819]
Tegnander E, Williams W, Johansen OJ, Blaas HGK, Eik-Nes SH. Prenatal detection of heart defects in a non-selected population of 30 149 fetuses-detection rates and outcome. Ultrasound Obstet Gynecol 2006; 27(3): 252-65.
[] [PMID: 16456842]
Ferencz C, Neill CA, Boughman JA, Rubin JD, Brenner JI, Perry LW. Congenital cardiovascular malformations associated with chromosome abnormalities: An epidemiologic study. J Pediatr 1989; 114(1): 79-86.
[] [PMID: 2521249]
Carvalho JS. Antenatal diagnosis of critical congenital heart disease. Optimal place of delivery is where appropriate care can be delivered. Arch Dis Child 2016; 101(6): 505-7.
[] [PMID: 26819268]
Donofrio MT, Moon-Grady AJ, Hornberger LK, et al. Diagnosis and treatment of fetal cardiac disease: A scientific statement from the American Heart Association. Circulation 2014; 129(21): 2183-242.
[] [PMID: 24763516]
Costello JM, Pasquali SK, Jacobs JP, et al. Gestational age at birth and outcomes after neonatal cardiac surgery: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Circulation 2014; 129(24): 2511-7.
[] [PMID: 24795388]
Costello JM, Polito A, Brown DW, et al. Birth before 39 weeks’ gestation is associated with worse outcomes in neonates with heart disease. Pediatrics 2010; 126(2): 277-84.
[] [PMID: 20603261]
Cucerea M, Simon M, Moldovan E, Ungureanu M, Marian R, Suciu L. Congenital heart disease requiring maintenance of ductus arteriosus in critically ill newborns admitted at a tertiary neonatal intensive care unit. J Crit Care Med (Targu Mures) 2016; 2(4): 185-91.
[] [PMID: 29967858]
Sanapo L, Moon-Grady AJ, Donofrio MT. Perinatal and delivery management of infants with congenital heart disease. Clin Perinatol 2016; 43(1): 55-71.
[] [PMID: 26876121]
Phi JH. Sacrococcygeal teratoma: A tumor at the center of embryogenesis. J Korean Neurosurg Soc 2021; 64(3): 406-13.
[] [PMID: 33906346]
Roybal JL, Moldenhauer JS, Khalek N, et al. Early delivery as an alternative management strategy for selected high-risk fetal Sacrococcygeal teratomas. J Pediatr Surg 2011; 46(7): 1325-32.
[] [PMID: 21763829]
Okada T, Sasaki F, Cho K, et al. Management and outcome in prenatally diagnosed Sacrococcygeal teratomas. Pediatr Int 2008; 50(4): 576-80.
[] [PMID: 18937757]
Goel P, Yadav DK, Acharya SK, Bagga D, Jain V, Dhua A. Sacrococcygeal teratoma: Clinical characteristics, management, and long-term outcomes in a prospective study from a Tertiary Care Center. J Indian Assoc Pediatr Surg 2020; 25(1): 15-21.
[] [PMID: 31896894]
Gupta N, Shah D, Singh U, Tiwari A. Antenatal diagnosis of large sacro-coccygeal teratoma with foetal cardiomegaly and hydrops. Kathmandu Univ Med J 1970; 6(3): 383-5.
[] [PMID: 20071824]
Smarius B, Loozen C, Manten W, Bekker M, Pistorius L, Breugem C. Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology. World J Methodol 2017; 7(3): 93-100.
Hlongwa P, Rispel LC. “People look and ask lots of questions”: caregivers’ perceptions of healthcare provision and support for children born with cleft lip and palate. BMC Public Health 2018; 18(1): 506.
[] [PMID: 29661170]
Duarte GA, Ramos RB, Cardoso MCAF. Feeding methods for children with cleft lip and/or palate: a systematic review. Rev Bras Otorrinolaringol (Engl Ed) 2016; 82(5): 602-9.
[] [PMID: 26997574]
Donovan K. Breastfeeding the infant with cleft lip and palate. Infant Child Adolesc Nutr 2012; 4(4): 194-8.
Goyal M, Chopra R, Bansal K, Marwaha M. Role of obturators and other feeding interventions in patients with cleft lip and palate: A review. Eur Arch Paediatr Dent 2014; 15(1): 1-9.
[] [PMID: 24425528]
Nagase H, Ohyama M, Yamamoto M, et al. Prenatal ultrasonographic findings and fetal/neonatal outcomes of body stalk anomaly. Congenit Anom (Kyoto) 2021; 61(4): 118-26.
[] [PMID: 33583092]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy