Screening for fetal spina bifida by ultrasound examination in the first trimester of pregnancy using fetal biparietal diameter

Introduction: Our aim was to examine the value of indirect signs of open spina bifida in the mid-sagittal view of the posterior brain at the 11-13 weeks' ultrasound examination and to summarize the current evidence for the first-trimester diagnosis of spina bifida. Methods: This was a prospective study in routine obstetric population. The presence of four almost parallel lines (four-line view) in the posterior brain was recorded. Biparietal diameter (BPD), intracranial translucency (IT) and cisterna magna (CM) were measured. The ratio of IT to CM (R ratio) was calculated. Results: 2,491 pregnancies were examined prospectively. Updated reference ranges for IT and CM were constructed. There were 3 cases with open spina bifida, and the four-line view was abnormal in 2 of them. The abnormal fetuses had smaller BPD as well as pronounced reduction in the CM and increase in the R ratio. Discussion: Examination of the posterior brain was feasible in all fetuses in the setting of the routine 11-13 weeks' ultrasound examination. Indirect signs of spina bifida are visible in the mid-sagittal view of the posterior brain, and the assessment of these structures can be a reliable tool in the early identification of this abnormality.

Download Full-text

136: Screening for placenta accreta by transvaginal ultrasound examination in the first trimester of pregnancy in women with prior caesarean delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.10.152 ◽

2011 ◽

Vol 204 (1) ◽

pp. S67-S68

Author(s):

Julien Stirnemann ◽

Silvana Forner ◽

Eve Mousty ◽

Gihad Chaloui ◽

Laurent Salomon ◽

...

Keyword(s):

Caesarean Delivery ◽

Ultrasound Examination ◽

Placenta Accreta ◽

Transvaginal Ultrasound ◽

First Trimester ◽

First Trimester Of Pregnancy

Download Full-text

Prenatal Tactics Of Ultrasonographic Examination Of The Fetus In Early Pregnancy

European Medical Health and Pharmaceutical Journal ◽

10.12955/emhpj.v4i0.359 ◽

2012 ◽

Vol 4 ◽

Author(s):

Shahnoza Kamalidinova

Keyword(s):

Pregnant Women ◽

Fetal Death ◽

Chromosomal Abnormalities ◽

Ultrasound Examination ◽

First Trimester ◽

Intrauterine Fetal Death ◽

Fetal Ultrasound ◽

Abnormal Pregnancy ◽

First Trimester Of Pregnancy ◽

Fetal Defects

To study defects and chromosomal abnormalities of the fetus, we retrospectively analyzed results of comprehensive dynamic survey of 26,404 pregnant women aged 18-50 years old at 6 to 40 weeks of pregnancy. Of them, 25,956 (98.3%) women had physiological course of pregnancy, 448 (1.7%) women had abnormal pregnancy. For the diagnosis of fetal defects, we carried out ultrasound, biochemical, invasive and cytogenetic studies. The results of study showed that the majority of fetal defects and pathological course of pregnancy was noted in women at the age of 21-25 years old, since at this age period women have the highest number of pregnancies. At the older age, we noted a gradual decrease in the number of pregnant women, as well as the number of abnormalities of the fetus. Based on the analysis of the results obtained, we have developed an algorithm for early fetal ultrasound examination. In order to exclude non-developing pregnancy and intrauterine fetal death, as well as for early diagnosis of fetal defects, we recommend screening women in the first trimester of pregnancy.

Download Full-text

Cost-effectiveness of routine ultrasound examination in first trimester of pregnancy

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/0028-2243(91)90133-6 ◽

1991 ◽

Vol 39 (1) ◽

pp. 3-6 ◽

Cited By ~ 3

Author(s):

M. Temmerman ◽

P. Buekens

Keyword(s):

Cost Effectiveness ◽

Ultrasound Examination ◽

First Trimester ◽

First Trimester Of Pregnancy

Download Full-text

Features of prenatal diagnostics of trisomy 9 in the first trimester of pregnancy

10.21516/2413-1458-2018-17-1-17-21 ◽

2018 ◽

Author(s):

E.I. Golovataya, I.V. Novikova

Keyword(s):

Prenatal Diagnosis ◽

Ultrasound Examination ◽

Chorionic Villus ◽

First Trimester ◽

Prenatal Diagnostics ◽

Trisomy 9 ◽

Cytogenetic Studies ◽

First Trimester Of Pregnancy ◽

Mosaic Form ◽

Mosaic Trisomy

We report about 4 cases of prenatal diagnostics of mosaic trisomy 9 in the first trimester of pregnancy. The data of ultrasound, cytogenetic and pathoanatomical studies are presented. Prenatal diagnosis of trisomy 9 is difficult due to the non-specificity of the anomalies characteristic of it. Trisomy 9 in complete or mosaic form in chorionic villus cells may not be confirmed in the fetal tissues. Interpreting the results of cytogenetic analysis of chorionic villus cells and deciding on the prognosis of pregnancy with trisomy 9, the whole complex of clinical data should be taken into account: the results of the ultrasound examination and additional cytogenetic studies, anamnesis

Download Full-text

First trimester cerebral appearance in the presence of closed spina bifida with myelomeningocele, part of the oeis complex

BMJ Case Reports ◽

10.1136/bcr-2020-235395 ◽

2020 ◽

Vol 13 (10) ◽

pp. e235395

Author(s):

Delia Roxana Ungureanu ◽

Lucian George Zorila ◽

Razvan Grigoras Capitanescu ◽

Dominic Gabriel Iliescu

Keyword(s):

Spinal Cord ◽

Spina Bifida ◽

First Trimester ◽

Cerebrospinal Fluid Leakage ◽

Good Neurological Outcome ◽

Careful Evaluation ◽

First Trimester Of Pregnancy ◽

Large Skin ◽

Open Spina Bifida ◽

Secondary Signs

Our communication presents a prenatally detected case with severe spinal defect detected in the first trimester of pregnancy, accompanied by a large skin-covered myelomeningocele but normal cranio-cerebral structural appearance.These findings suggest that in the first trimester, the extent of the spinal defect, the cerebrospinal fluid leakage to a large, but skin-covered, meningocele and fixation of the spinal cord at the lesion are not sufficient to determine downward hindbrain displacement and the development of secondary signs for open spina bifida.Therefore, we suggest a careful evaluation of the fetal cerebral features if a meningocele is detected. The presence of the skin covering the lesion may not be evident in the first trimester, but the absence of intracranial open spina bifida markers may indicate a ‘closed’ spinal defect, which generally associates a good neurological outcome. Also, studies aimed to investigate the accuracy of the intracranial features for open spina bifida detection should consider the possibility of ‘closed’ myelomeningoceles to avoid incorrect correlations.

Download Full-text

Normal intracranial BS/BSOB ratio values in the first trimester of single gestations with live fetuses in a Korean population

Medical Ultrasonography ◽

10.11152/mu-829 ◽

2017 ◽

Vol 19 (2) ◽

pp. 190

Author(s):

Sung Hee Yang ◽

Hyun Sook An ◽

Jin Soo Lee ◽

Changsoo Kim

Keyword(s):

Spina Bifida ◽

First Trimester ◽

Cross Sectional Study ◽

Korean Women ◽

Sectional Study ◽

Cross Sectional ◽

Gestational Period ◽

Reference Marker ◽

Routine Measurement ◽

First Trimester Of Pregnancy

Aim: The purpose of this study was to determine the normal length of the brainstem (BS) in Korean fetuses and to evaluatethe usefulness of the routine measurement of BS size in the first trimester of pregnancy for the early detection of spina bifida.Material and methods: A total of 2,621 normal singleton pregnant Korean women at 10+6 to 13+6 weeks of gestation were selected for this retrospective cross-sectional study. Ultrasonography was used to measure the length of the longest vertical depth diameter of the BS and brainstem-occipital bone (BSOB) in order to obtain the BS to BSOB ratio.Results: The best indicators for spina bifida ranged from 1.00±0.24 mm to 4.70±0.46 mm for the BS and from 2.90±0.36 mm to 8.50±0.92 mm for the BSOB. For the gestational period, BS (R=0.70) and BSOB (R=0.81) values were considered statistically significant (p<.0001). The value of the BS to BSOB ratio was <1.0 in normal fetuses, and was not correlated with the gestational age.Conclusion: Measurement of BS and BSOB diameter in the first trimester is thought to provide the best reference marker for evaluating the posterior brain for diagnosis of spina bifida.

Download Full-text