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Prenatal diagnosis of diastematomyelia: presentation of eight cases and review of the literature
Author(s) -
Has R.,
Yuksel A.,
Buyukkurt S.,
Kalelioglu I.,
Tatli B.
Publication year - 2007
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.4066
Subject(s) - diastematomyelia , medicine , prenatal diagnosis , pregnancy , spina bifida , holoprosencephaly , fetus , encephalocele , obstetrics , pediatrics , spinal cord , surgery , psychiatry , biology , genetics
Objectives Diastematomyelia is a rare form of spinal dysraphism. We present eight cases of diastematomyelia diagnosed prenatally in our institution as well as a review of the literature in order to determine the prognosis of isolated cases of this very unusual condition. Methods Records of fetuses with diastematomyelia diagnosed in our institution between January 2000 and June 2005 were collected. All liveborn fetuses were examined by a pediatric neurologist. Pre‐ and postnatal data were analyzed. A search was then conducted using PubMed to review previously reported cases in the literature. Results Eight cases of diastematomyelia were diagnosed during the study interval. The mean (range) gestational age at diagnosis was 21 (13–25) weeks. The main sonographic findings were widening of the spinal canal in the coronal view and an additional echogenic focus in the posterior part of the spinal column in the axial view. The diagnosis of associated open spina bifida was made in one fetus with elevated levels of amniotic fluid α‐fetoprotein (AF‐AFP) and acetylcholinesterase (AF‐AChE) and the pregnancy was terminated. The other seven cases of diastematomyelia had normal levels of AF‐AFP and AF‐AChE and were considered isolated. One pregnancy miscarried spontaneously 1 week following amniocentesis and the remaining six were delivered at term. Review of the literature revealed 14 reports involving 26 cases of prenatally diagnosed diastematomyelia. Twelve cases had normal biochemistry and/or no additional abnormalities and all had a favorable outcome. Conclusions When diastematomyelia is not associated with other spinal anomalies, the prognosis is favorable. Prenatal diagnosis is generally made in the second trimester but sonographic signs may be recognized as early as the first trimester. Intrauterine diagnosis of diastematomyelia should facilitate appropriate management of affected cases. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.