Prenatal diagnosis and postnatal outcome of closed spinal dysraphism.
- Resource Type
- Academic Journal
- Authors
- Bedei I; Department of Prenatal Diagnosis and Fetal Therapy, Justus-Liebig University, Giessen, Germany.; Baylor College of Medicine Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery and Texas Children's Hospital Fetal Center, Houston, Texas, USA.; Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.; Krispin E; Boston Children's Hospital, Brigham and Women's Hospital, Beth Israel Deacones Medical Center, Harvard Medical School, Boston, Massachusetts, USA.; Sanz Cortes M; Baylor College of Medicine Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery and Texas Children's Hospital Fetal Center, Houston, Texas, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.; Lombaard H; Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.; Zemet R; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.; Whitehead WE; Department of Neurosurgery, Texas Children's Hospital & Baylor College of Medicine, Houston, Texas, USA.; Belfort MA; Baylor College of Medicine Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery and Texas Children's Hospital Fetal Center, Houston, Texas, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas, USA.; Huisman TAGM; Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
- Source
- Publisher: Wiley Country of Publication: England NLM ID: 8106540 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0223 (Electronic) Linking ISSN: 01973851 NLM ISO Abbreviation: Prenat Diagn Subsets: MEDLINE
- Subject
- Language
- English
Objective: To evaluate the prenatal diagnosis of closed dysraphism (CD) and its correlation with postnatal findings and neonatal adverse outcomes.
Methods: A retrospective cohort study including pregnancies diagsnosed with fetal CD by prenatal ultrasound (US) and magnetic resonance imaging (MRI) at a single tertiary center between September 2011 and July 2021.
Results: CD was diagnosed prenatally and confirmed postnatally in 12 fetuses. The mean gestational age of prenatal imaging was 24.2 weeks, in 17% the head circumference was ≤fifth percentile and in 25% the cerebellar diameter was ≤fifth percentile. US findings included banana sign in 17%, and lemon sign in 33%. On MRI, posterior fossa anomalies were seen in 33% of cases, with hindbrain herniation below the foramen magnum in two cases. Mean clivus-supraocciput angle (CSA) was 74°. Additional anomalies outside the CNS were observed in 50%. Abnormal foot position was demonstrated prenatally in 17%. Neurogenic bladder was present in 90% of patients after birth.
Conclusion: Arnold Chiari II malformation and impaired motor function can be present on prenatal imaging of fetuses with CD and may be associated with a specific type of CD. Prenatal distinction of CD can be challenging. Associated extra CNS anomalies are frequent and the rate of neurogenic urinary tract dysfunction is high.
(© 2023 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.)