CHSJ

Curr Health Sci J, vol. 49, no. 3, 2023

Open Spina Bifida: The Role of Ultrasound Markers in the First Trimester and Morphopathology Correlation

[Case Report]

D.R. UNGUREANU(1), M.C. COMANESCU(2), A.M. ISTRATE-OFITERU(3,4), G.L. ZORILA(5,6), R.C. DRAGUSIN(5,6), D.G. ILIESCU(5,6)


(1)Doctoral School, University of Medicine and Pharmacy of Craiova, Romania;
(2)Department of Anatomy, University of Medicine and Pharmacy of Craiova, Romania;
(3)Department of Histology, University of Medicine and Pharmacy of Craiova, Romania;
(4)Research Centre for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania;
(5)Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania;
(6)Department of Obstetrics and Gynecology, Emergency Clinical County Hospital, Craiova, Romania


Abstract:

Objectives-To evaluate ultrasound markers during a first-trimester (FT) routine ultrasound examination for an early detection of open spina bifida (OSB) and to correlate the sonographic findings with the morpho-histological ones. Materials and Methods: This retrospective research was performed using data from foetuses that underwent FT anatomy scans (FTAS) with a gestational age between 11 weeks and 13 weeks and 6 days in the Prenatal Diagnostic Unit of the Clinical Emergency County Hospital Craiova from October 2022 until September 2023. Results: The study included 648 FT singleton pregnancies and 5 OSB cases were detected. In the OSB group, we found abnormal aspects of the fourth ventricle, also named intracranial translucency (IT) in 4 out of 5 cases of OSB (80%), a brain stem anteroposterior diameter, and brain stem to occipital bone ratio abnormal in all 5 cases (greater than 1) (100%), the crash sign was present in 80% (4 out of 5 cases) and the spinal defect was visualized in 4 out of 5 patients (80%). Medical termination of pregnancy (MTOP) was the preferred option in all cases of OSB. This allowed us to include an extended histological study to confirm the ultrasound diagnosis. Conclusions: A combined detailed FTAS that includes both cranial ultrasound markers of the posterior fossa and also a good visualization of the foetal spine offers an early optimal detection rate of spine abnormalities.


Keywords: Prenatal diagnosis, ultrasound, anomaly scan, spina bifida.



Corresponding: Corresponding Author


DOI 10.12865/CHSJ.49.03.20 - Download PDF
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