Neonatal outcomes of foetal micrognathia: An 11-year review.

ABSTRACT

AIM: To identify antenatal features associated with foetal micrognathia that can predict a challenging postnatal management, including difficult airway at delivery, feeding problems and impaired neurological outcomes. METHODS: Single-centre retrospective observational study. Data for antenatally diagnosed cases of micrognathia over 11 years were obtained and analysed. RESULTS: A total of 38 cases were identified, 20 were live births. Of the 16 inborn infants, all had associated congenital anomalies 14 were diagnosed antenatally, two postnatally. Six of the 16 infants had difficult intubation at birth and three required a tracheostomy. Three died in the neonatal period. The risk of requiring respiratory support at discharge or death was increased if any anomaly was diagnosed antenatally (p = 0.05). There were no differences in respiratory or gastrointestinal morbidities for infants where polyhydramnios was detected antenatally. Of the 13 survivors, two were orally fed, five required a gastrostomy and six were fed by nasogastric/nasojejunal tube. Ten infants were followed up after discharge and seven had normal neurological outcomes. CONCLUSION: There remains no predictive tool available antenatally to anticipate neonatal outcomes. Our associated mortality rate was 64%. Foetal micrognathia rarely occurs in isolation and each case should be referred to a specialist centre for optimal counselling and careful planning.