Document Detail


Fetal open spina bifida: a natural history of disease progression in utero.
MedLine Citation:
PMID:  15065103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the natural history of the prenatal development of ventriculomegaly and talipes in fetuses with open spina bifida. STUDY DESIGN: All fetuses with isolated open spina bifida and managed at our center between January 1996 and March 2000 were retrospectively evaluated. Ultrasonographic images and reports were reviewed from examinations performed every 3 to 4 weeks from the time of diagnosis to delivery for lesion level and type, ventriculomegaly (defined as an atrial width of > or =10 mm), and lower extremity appearance. RESULTS: Of the 53 pregnancies identified, 20 (38%) were electively terminated. In the 33 ongoing gestations, the lesions ranged from lower thoracic to sacral; 79% were characterized as meningomyeloceles and 21% as myeloschises. Fifty-five percent (n = 18) had ventriculomegaly at diagnosis (early onset, mean gestational age at diagnosis 22 +/- 5 weeks), 33% (n = 11) subsequently developed ventriculomegaly (late onset, mean 29 +/- 6 weeks), and 12% (n = 4) had normal ventricle size at the last sonogram before birth (mean 38 +/- 1 weeks). The ventricular size prior to delivery was significantly smaller with late-onset ventriculomegaly than with early-onset: 15 +/- 4 mm versus 28 +/- 10 mm, (p = 0.001). Only 6% (n = 2) had talipes at the initial sonogram, and 18% (n = 6) were subsequently determined to have talipes (mean 30 +/- 6 weeks). CONCLUSION: Most fetuses with open spina bifida develop ventriculomegaly, and the majority do so by 21 weeks' gestation. Fetuses that develop ventriculomegaly later in gestation have less severe ventricular dilation at birth. In contrast, a minority of fetuses have congenital talipes, and because most cases develop after 20 weeks, they are not predicted by early midtrimester sonographic evaluation.
Authors:
Joseph R Biggio; Katharine D Wenstrom; John Owen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  24     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-05     Completed Date:  2004-07-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  287-9     Citation Subset:  IM    
Copyright Information:
Copyright 2004 John Wiley & Sons, Ltd.
Affiliation:
University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Reproductive Genetics, Birmingham, Alabama 35249-7333, USA. jbiggio@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Cerebral Ventricles / ultrasonography
Equinus Deformity
Female
Gestational Age
Humans
Pregnancy
Retrospective Studies
Spina Bifida Cystica / embryology,  ultrasonography*
Ultrasonography, Prenatal*

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