Prenatal sonographic diagnosis of hemivertebrae: associations and outcomes.
OBJECTIVE
The purpose of this study was to evaluate associated anomalies and outcomes of fetuses with prenatally diagnosed hemivertebrae.


METHODS
Fetuses with prenatally diagnosed hemivertebrae, excluding those associated with spina bifida, were identified by searching the prospectively maintained ultrasound databases of 4 institutions from 1997 to August 2007. Associated birth defects were tabulated by organ system and hemivertebra location. Outcomes included karyotypes, gestational ages, and routes and outcomes of deliveries.


RESULTS
Nineteen fetuses had a diagnosis of hemivertebrae at a mean gestational age +/- SD of 20.5 +/- 5.4 weeks. Fourteen (73.7%) fetuses had additional anomalies, of which 5 (35.7%) were syndromic (4 with cloacal exstrophy and omphaloceles and 1 with Jarcho-Levin syndrome). Karyotypes were normal in all 11 available cases, each of which had additional anomalies. Fourteen (73.7%) neonates were live born at a mean gestational age of 34.9 +/- 4.3 weeks, of which 7 (50%) were born by cesarean delivery. Ten neonates (71.4%) were delivered before term, and 4 (28.6%) were growth restricted (<10th percentile). Two (14.3%) of these neonates died; both had cloacal exstrophy and large omphaloceles. The remaining pregnancies were terminated (4 [21.1%]) or had a fetal death (1 [5.3%]).


CONCLUSIONS
Most fetuses with prenatally diagnosed hemivertebrae have additional anomalies, often syndromic, which affect the prognosis. Affected pregnancies have high rates of cesarean delivery and growth restriction. Neonates with nonisolated hemivertebrae are more often delivered before term and have higher mortality rates.
Wax
Joseph R
JR
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, Maine, USA. waxj@mmc.org
Watson
William J
WJ
Miller
Richard C
RC
Ingardia
Charles J
CJ
Pinette
Michael G
MG
Cartin
Angelina
A
Grimes
Charles K
CK
Blackstone
Jacquelyn
J
D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000028:Abortion, Induced / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016208:Databases, Factual; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging; D013131:Spine / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D013577:Syndrome; D016216:Ultrasonography, Prenatal / Q000379:methods*