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Variations in genital development (VDG) account for 0.5% to 1% of births. Advances in ultrasound techniques, as well as in prenatal diagnosis techniques, particularly in genetics, have led to improvements in the prenatal diagnosis of these pathologies. However, to date, there is no consensus on etiological research and standardized management of these patients and their families, once VDG has been detected.
The value of multidisciplinary management has already been demonstrated, but a number of grey areas remain: the frequency of false-positive ultrasound findings, the place of invasive antenatal diagnostic tests, the role left to parents during the diagnostic process, the frequency of associated malformations discovered post-natally, and how to prepare for immediate management at birth.
The aim of this study is to improve the management of patients and their families as soon as a Disorders of Sexual Development is detected antenatally.
The primary objective is to describe the management, particularly complementary investigations performed in the antenatal management of ultrasound diagnoses of Disorders of Sexual Development over the last 10 years.
The secondary objectives are :
To determine the correlation between pre- and post-natal morphological phenotype and the proportion of false positives in antenatal ultrasound diagnosis.
To characterize prenatally diagnosed Disorders of Sexual Development
To determine the proportion of isolated prenatally-diagnosed Disorders of Sexual Development that turn out not to be isolated during postnatal follow-up.
The evaluation of the care pathway :
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| All fetuses referred to the HFME and Croix Rousse CPDPNs for antenatal diagnostic consultation (DAN) | Non-interventional retrospective study, only on datas for suspected isolated variation in genital development (VDG) |
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| Measure | Description | Time Frame |
|---|---|---|
| Ancillary Study of Retrospective Analysis of Neonatal Management of Patients with ANtenatal Diagnosis of Variation of Genital Development at Lyon Hospital | Number and type of complementary investigations performed as part of antenatal management following ultrasound diagnoses of Disorders of Sexual Development over the past 10 years. | From January 2013 to December 2022. |
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Inclusion Criteria:
Fetuse of the hospital Femme-Mère-Enfant, the hospital Croix Rousse and Lyon-Sud hospital, reffered to Pluridisciplinary Centers for Prenatal Diagnosis (CPDPNs) for antenatal diagnosis (DAN) for a suspected isolated Disorders of Sexual Development (DSD) from January 2013 to December 2022.
Intrauterine growth retardation (RCIU), a muscular or minor ventricular septal defect, or a pyloric dilatation are not considered as an associated malformation.
Exclusion Criteria:
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All fetuses referred to the hospital Femme-Mère-Enfant and the hospital Croix Rousse Pluridisciplinary Centers for Prenatal Diagnosis (CPDPNs), for antenatal diagnosis (DAN) for a suspected isolated Disorders of Sexual Development (DSD) from 01/01/2013 to 31/12/2023.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service d'endocrinologie pédiatrique HFME | Bron | 69500 | France |
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| ID | Term |
|---|---|
| D012734 | Disorders of Sex Development |
| D006059 | Gonadal Dysgenesis |
| D007021 | Hypospadias |
| D001746 | Bladder Exstrophy |
| D014424 | Turner Syndrome |
| D007713 | Klinefelter Syndrome |
| D006060 | Gonadal Dysgenesis, Mixed |
| D050090 | Ovotesticular Disorders of Sex Development |
| ID | Term |
|---|---|
| D014564 | Urogenital Abnormalities |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
| D010409 | Penile Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D058533 | Sex Chromosome Disorders of Sex Development |
| D006330 | Heart Defects, Congenital |
| D018376 | Cardiovascular Abnormalities |
| D002318 | Cardiovascular Diseases |
| D006331 | Heart Diseases |
| D025064 | Sex Chromosome Disorders |
| D025063 | Chromosome Disorders |
| D030342 | Genetic Diseases, Inborn |
| D007006 | Hypogonadism |
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