Intracranial ultrasonographic findings in open spina bifida

M. Steriu, R.E. Bohîlțea, B.M. Mihai, A.I. Toma, R.D. Bogdan, V. Dima, D. Nemescu

Rezumat: Spina bifida aperta is one of the most frequent open neural tube defects and consists in a closure defect in the fetal spine and the subsequent skin, leaving the spinal cord vulnerable. Since folic acid supplementation has been recommended periconceptionally, the incidence of neural tube defects, including spina bifida, has been reduced dramatically. Unfortunately, spina bifida is usually diagnosed in the second trimester, more frequently between 18 and 20 weeks of gestation, according to the American College of Obstetricians and Gynecologists (ACOG), by visualizing the spinal defect, as well as well-known intracranial signs. There have been attempts in finding the right intracranial sign or measurement that can predict a future positive diagnosis of spina bifida or at least alert the sonographer to further investigate. The early diagnosis of spina bifida represents the subject of interest of this paper, as this congenital neural tube defect carries the burden of a significant morbidity. The mothers should be counseled, informed about the fetal complications of this pathology and about the therapeutic possibilities, including intrauterine fetal surgery, and they should also be given the possibility of pregnancy termination, if the patient decides in this direction.
Cuvinte cheie: spina bifida, early signs, intracranial translucency, brain stem, mesencephalon to occiput diameter.