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Prenatal diagnosis of open and closed spina bifida
Author(s) -
Ghi T.,
Pilu G.,
Falco P.,
Segata M.,
Carletti A.,
Cocchi G.,
Santini D.,
Bonasoni P.,
Tani G.,
Rizzo N.
Publication year - 2006
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.3865
Subject(s) - spina bifida , medicine , prenatal diagnosis , pediatrics , spina bifida occulta , surgery , fetus , obstetrics , pregnancy , biology , genetics
Objective To identify criteria useful for differentiating closed from open spina bifida antenatally. Patients and methods A retrospective study of cases of spina bifida diagnosed in a referral center between 1997 and 2004. Results Of 66 cases of fetal spina bifida diagnosed at a median gestational age of 21 (range, 16–34) weeks, detailed follow‐up was available for 57. Of these, open defects were found in 53 (93.0%) and closed defects in four (7.0%). Closed spina bifida was associated in two cases with a posterior cystic mass with thick walls and a complex appearance, while in two cases the spinal lesion could not be clearly differentiated from an open defect, particularly at mid‐gestation. Open spina bifida was always associated with typical alterations of cranial anatomy, including the so‐called ‘banana’ and ‘lemon’ signs, while in closed spina bifida the cranium was unremarkable. When the data were available, levels of amniotic fluid alpha‐fetoprotein were always abnormally elevated with open spina bifida and within normal limits with closed forms. Conclusion In this study 7% of cases of spina bifida diagnosed in utero were closed. The differentiation between open and closed forms is best shown by the sonographic demonstration of abnormal or normal cranial anatomy. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.