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

Prevalence 2.3/ 10 000 births Prevalence steady within last few decades

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

Preconceptional/periconceptional FA recommendations in Finland

Out-of-date already at the time of publication !!

Preconceptional/periconceptional FA recommendations in Finland

New guidelines to be published before summer 2015

Low-risk women included Intermediate-risk group still not well-defined

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)?

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