New insights in cerebral findings associated with fetal myelomeningocele: a retrospective cohort study in a single tertiary centre.
Cerebral anomalies
corpus callosum
myelomeningocele
prenatal diagnosis
ultrasound
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
accepted:
17
02
2020
pubmed:
1
3
2020
medline:
5
3
2021
entrez:
1
3
2020
Statut:
ppublish
Résumé
To investigate cerebral anomalies other than Chiari type 2 malformation in fetuses with myelomeningocele (MMC). A retrospective cohort study in a single tertiary centre. A review of associated cerebral anomalies in cases with prenatal diagnosis of myelomeningocele. Seventy cases of fetal myelomeningocele. Ultrasound and MRI images were blindly reviewed. Postnatal imaging and results of the postmortem results were also reviewed. The association between cerebral anomalies and the following ultrasound findings was measured: level of the defect, ventriculomegaly, microcephaly and fetal talipes. A microcephaly was observed in 32/70 cases (46%) and a ventriculomegaly was observed in 39/70 cases (56%). Other cerebral anomalies were diagnosed in 47/70 (67%). Other cerebral anomalies were represented by 42/70 cases with abnormal CC (60%), 8/70 cases with perinodular heterotopia (PNH; 11%), 2/70 cases with abnormal gyration (3%). MRI performed only in fetal surgery cases confirmed the ulltrasound findings in all cases and provided additional findings in two cases (PNH). Risk ratios of fetal cerebral anomalies associated with MMC did not reach significance for microcephaly, ventriculomegaly, talipes or the level of the defect There was an overall good correlation between pre- and postnatal findings with a Kappa value of 0.79 [95% CI 0.57-1] and 82% agreement. Fetal brain anomalies other than Chiari type 2 malformation are frequently observed in fetuses with myelomeningocele, predominantly represented by CC anomalies. Whether these associated cerebral anomalies have an impact on selecting cases eligible for fetal surgery needs further evaluation. Fetal cerebral anomalies other than Chiari type 2 malformation, microcephaly, and ventriculomegaly may be associated with MMC in up to 67% of the cases.
Identifiants
pubmed: 32112473
doi: 10.1111/1471-0528.16185
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
376-383Subventions
Organisme : Programme Hospitalier de Recherche Clinique-PHRC 2013 (French Ministry of Health)
Informations de copyright
© 2020 Royal College of Obstetricians and Gynaecologists.
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