Table 3.
Various clinical combinations and the counseling options which may be recommended to parents based on Management, Outcome, Risk, and Expectation
| MORE category | MORE combination | Example |
|---|---|---|
| Continue pregnancy, good or fair prognosis | M1 | Mild hydronephrosis UTD A1 |
| O1 | Isolated soft markers such as choroid plexus cysts, echogenic cardiac foci, echogenic bowel | |
| R1 | ||
| E1 | ||
| O2 | ||
| R2 | ||
| E2 | ||
| Shared decision-making | M2 | Abdominal wall defect (low-risk types - exomphalos minor, perinatal gastroschisis) |
| PUV/hydronephrosis without oligohydramnios | ||
| Esophageal, duodenal, jejunoileal, and anorectal atresias | ||
| Meconium ileus | ||
| Enteric cysts and duplications | ||
| Small intact meningocele | ||
| Unilateral hydronephrosis | ||
| Craniofacial, extremity, and chest wall deformities | ||
| Cystic hygromas | ||
| Small sacrococcygeal teratoma, mesoblastic nephroma, etc. | ||
| Benign cysts: Ovarian, mesenteric, choledochal, etc. | ||
| M4 | PUV with complications/oligohydramnios | |
| O3 | Myelomeningocele | |
| R2 | Exstrophy bladder | |
| E2 | Cleft lip and palate | |
| M3 | PUV with severe oligohydramnios/anhydramniossss | |
| O3 | Severe myelomeningocele/myeloschisis | |
| R2 | Severe hydrocephalus | |
| E2 | Large CPAM | |
| High-risk CDH | ||
| Large sacrococcygeal teratoma | ||
| Large cystic hygroma | ||
| 21 hydroxylase deficiency (Need to follow the evidence on indications/safety/feasibility/efficacy of fetal intervention) | ||
| M4 | VACTERL | |
| O4 | Associated Major heart defect with a system anomaly | |
| R2 | ||
| E2 | ||
| Termination is offered, final decision by parents | M5 | Anencephaly |
| O5 | Bilateral PCKD | |
| R3 | Bilateral renal agenesis | |
| E3 | Eisenmenger’s syndrome/severe pulmonary hypertension | |
| Severe anomalies associated with confirmed chromosomal abnormalities (e.g., trisomy 13) |
MORE: Management, Outcome, Risk, and Expectation, CDH: Congenital diaphragmatic hernia, PUV: Posterior urethral valve, PCKD: PolyCystic kidney disease, CPAM: Congenital pulmonary adenomatoid malformation, UTD A1: Urinary Tract Dilation Classification (Mild Category)