title: Association between prenatal sonographic findings and post-natal outcomes in 30 cases of isolated spina bifida aperta.
abstract: This study presents 30 cases of fetal isolated spina bifida aperta (SBA) to identify prenatal ultrasound findings that could predict the prognosis. Comparisons between surviving patients who had normal (group 1) and abnormal (group 2) post-natal neurological outcomes were made for three different prenatal signs, that is, site of vertebral lesion, presence and degree of ventriculomegaly and presence of talipes. The site of the lesion was the most significant outcome predictor, as high spinal dysraphisms were observed in 2 patients (2/7-28.6%) in group 1 and in 15 patients (15/19-79.0%) in group 2 (p = 0.03). The presence of fetal ventriculomegaly was associated with impaired post-natal neurological development, as it occurred in 4 patients (4/7-57.1%) in group 1 and in 18 patients (18/19-94.7%) in group 2 (p = 0.04). The presence of talipes did not significantly differ between the two groups. Patients with abnormal intellectual outcome (8/26-30.8%) had significantly greater (p = 0.018) lateral ventricle/hemisphere ratios (mean = 0.74, standard deviation = 0.13) than those with normal intellectual development (mean = 0.54, standard deviation = 0.18). Mean post-natal follow-up was at 23 months (standard deviation = 15 months).
authors.affiliation: Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of São Paulo, Medical School Hospital, São Paulo, Brazil.
authors.forename: Cleisson Fábio A
authors.initials: CF
authors.lastname: Peralta
authors.forename: Victor
authors.initials: V
authors.lastname: Bunduki
authors.forename: José Píndaro P
authors.initials: JP
authors.lastname: Plese
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
authors.forename: Javier
authors.initials: J
authors.lastname: Miguelez
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000015:Abnormalities, Multiple / Q000209:etiology / Q000473:pathology; D000328:Adult; D005260:Female; D005544:Forecasting / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D016137:Spina Bifida Cystica / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D016216:Ultrasonography, Prenatal