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Fetal Open and Closed Spina Bifida on a Routine Scan at 11 Weeks to 13 Weeks 6 Days
Author(s) -
Liao Yimei,
Wen Huaxuan,
Luo Guoyang,
Ouyang Shuyuan,
Bi Jingru,
Yuan Ying,
Luo Dandan,
Huang Yi,
Zhang Kui,
Tian Xiaoxian,
Li Shengli
Publication year - 2021
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.15392
Subject(s) - medicine , spina bifida , ultrasound , pregnancy , surgery , obstetrics , radiology , genetics , biology
Objectives This study aimed to determine the sensitivity of a first‐trimester routine scan in detecting spina bifida (SB) and evaluating the first‐trimester intracranial signs. Methods This retrospective study was a review of a prospectively collected database. All cases of SB diagnosed in a tertiary center from 2008 to 2015 were identified. The ultrasound images and medical records were reviewed. All cases of SB diagnosed prenatally were confirmed at birth or autopsy. Results A total of 24 cases of SB were diagnosed from 53,349 pregnancy cases. Except for 10 cases with a body stalk anomaly, craniorachischisis, or iniencephaly, 7 cases with open spina bifida (OSB) and 7 cases with closed spina bifida (CSB) were analyzed. The first‐trimester detection rates were 100% (7 of 7) for OSB and 28.5% (2 of 7) for CSB. Eight cases were highly suspected of SB in the first trimester because of an abnormal appearance of the posterior brain; 3 were false‐positive cases. Two isolated cases of OSB had first‐trimester intracranial signs. An obliterated cisterna magna (CM) showed the highest sensitivity for OSB but low specificity. Two cases of OSB had no discernible landmark of intracranial translucency and the CM, and 4 showed normal intracranial translucency with an obliterated CM. All CSB cases were coupled with a normal hind brain except for 2 cases. Conclusions A first‐trimester routine scan has high sensitivity in screening for OSB. The CM may be the most sensitive intracranial sign.