Association between prenatal sonographic findings and post-natal outcomes in 30 cases of isolated spina bifida aperta.
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).
Peralta
Cleisson Fábio A
CF
Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of São Paulo, Medical School Hospital, São Paulo, Brazil.
Bunduki
Victor
V
Plese
José Píndaro P
JP
Figueiredo
Eberval Gadelha
EG
Miguelez
Javier
J
Zugaib
Marcelo
M
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