Antenatal ultrasound compared to MRI evaluation of fetal myelomeningocele: a prenatal and postnatal evaluation
-
Jessian L. Munoz
,
Elaine Bishop
Abstract
Background
Spina bifida affects 0.5–1 in 1000 pregnancies in the United States and is often diagnosed in the mid-second trimester. The objective of the study was to directly compare ultrasounds (US) and magnetic resonance imaging (MRI) obtained in the antenatal period in the diagnosis and localization of fetal myelomeningocele (MMC) and compare these with the postnatal outcomes of these infants
Methods
A retrospective analysis of patients referred to the Fetal Care Center at the Cleveland Clinic from 2005 to 2017. US and MRIs were obtained from the Cleveland Clinic electronic medical record. Infants were followed-up at an interdisciplinary myelomeningocele pediatrics clinic.
Results
MRI and US varied in correlation with physical exam at the time of birth and surgery. While no differences were detected in demographics, pregnancy outcomes or pediatric outcomes, it was noted that the majority of patients developed neurogenic bladders irrespective of the lesion level.
Conclusion
MRI is not superior to US in the diagnosis of MMC. Pregnancies complicated by MMC do not vary in morbidity, and pediatric outcomes remain similar regardless of the lesion level. This data provides additional information for the counseling of patients when faced with this antenatal diagnosis.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Blencowe H, Kancherla V, Moorthie S, Darlison MW, ModellB. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Ann N Y Acad Sci 2018;1414:31–46.10.1111/nyas.13548Suche in Google Scholar PubMed
2. Borgstedt-Bakke JH, Fenger-Gron M, Rasmussen MM. Correlation of mortality with lesion level in patients with myelomeningocele: a population-based study. J Neurosurg Pediatr 2017;19:227–31.10.3171/2016.8.PEDS1654Suche in Google Scholar PubMed
3. Wilson RD, SOGC Genetics Committee, Special Contributor. Prenatal screening, diagnosis, and pregnancy management of fetal neural tube defects. J Obstet Gynaecol Can 2014;36:927–39.10.1016/S1701-2163(15)30444-8Suche in Google Scholar PubMed
4. Copp AJ, Adzick NS, Chitty LS, Fletcher JM, Holmbeck GN, Shaw GM. Spina bifida. Nat Rev Dis Primers 2015;1:15007.10.1038/nrdp.2015.7Suche in Google Scholar PubMed PubMed Central
5. Carreras E, Maroto A, Illescas T, Melendez M, Arevalo S, Peiro JL, et al. Prenatal ultrasound evaluation of segmental level of neurological lesion in fetuses with myelomeningocele: development of a new technique. Ultrasound Obstet Gynecol 2016;47:162–7.10.1002/uog.15732Suche in Google Scholar PubMed
6. Trigubo D, Negri M, Salvatico RM, Leguizamon G. The role of intrauterine magnetic resonance in the management of myelomenigocele. Childs Nerv Syst 2017;33:1107–11.10.1007/s00381-017-3418-xSuche in Google Scholar PubMed
7. Appasamy M, Roberts D, Pilling D, Buxton N. Antenatal ultrasound and magnetic resonance imaging in localizing the level of lesion in spina bifida and correlation with postnatal outcome. Ultrasound Obstet Gynecol 2006;27:530–6.10.1002/uog.2755Suche in Google Scholar PubMed
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Corner of Academy
- Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study
- Original Articles – Obstetrics
- Poor sleep quality is associated with perinatal depression. A systematic review of last decade scientific literature and meta-analysis
- The predictive value of serum cancer antigen 125 (CA125) levels on pregnancy outcome in threatened miscarriages
- Pregnancy outcomes after thyroid cancer
- Maternal and perinatal outcomes in external cephalic version: prognostic factors for the success of the technique
- Association of dietary intake below recommendations and micronutrient deficiencies during pregnancy and low birthweight
- The sFlt-1/PlGF ratio values within the <38, 38–85 and >85 brackets as compared to perinatal outcomes
- Effect of bisphenol-A (BPA) on placental biomarkers for inflammation, neurodevelopment and oxidative stress
- Standard and adjusted criteria for the use of the misoprostol vaginal insert for labor induction: a comparative cohort study
- New reference values for biometrical measurements and sonographic estimated fetal weight in twin gestations and comparison to previous normograms
- Simultaneous analysis of bisphenol A fractions in maternal and fetal compartments in early second trimester of pregnancy
- Original Articles – Fetus
- Antenatal ultrasound compared to MRI evaluation of fetal myelomeningocele: a prenatal and postnatal evaluation
- The value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) parameters in analysis with fetal malnutrition neonates
- Carboxyhemoglobin in umbilical cord blood and maternal smoking
- Original Article – Newborn
- Macronutrient analysis of preterm human milk using mid-infrared spectrophotometry
Artikel in diesem Heft
- Frontmatter
- Corner of Academy
- Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study
- Original Articles – Obstetrics
- Poor sleep quality is associated with perinatal depression. A systematic review of last decade scientific literature and meta-analysis
- The predictive value of serum cancer antigen 125 (CA125) levels on pregnancy outcome in threatened miscarriages
- Pregnancy outcomes after thyroid cancer
- Maternal and perinatal outcomes in external cephalic version: prognostic factors for the success of the technique
- Association of dietary intake below recommendations and micronutrient deficiencies during pregnancy and low birthweight
- The sFlt-1/PlGF ratio values within the <38, 38–85 and >85 brackets as compared to perinatal outcomes
- Effect of bisphenol-A (BPA) on placental biomarkers for inflammation, neurodevelopment and oxidative stress
- Standard and adjusted criteria for the use of the misoprostol vaginal insert for labor induction: a comparative cohort study
- New reference values for biometrical measurements and sonographic estimated fetal weight in twin gestations and comparison to previous normograms
- Simultaneous analysis of bisphenol A fractions in maternal and fetal compartments in early second trimester of pregnancy
- Original Articles – Fetus
- Antenatal ultrasound compared to MRI evaluation of fetal myelomeningocele: a prenatal and postnatal evaluation
- The value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) parameters in analysis with fetal malnutrition neonates
- Carboxyhemoglobin in umbilical cord blood and maternal smoking
- Original Article – Newborn
- Macronutrient analysis of preterm human milk using mid-infrared spectrophotometry
