Work

The ultrasonographic features correlated with the morphopathological aspects in open spina bifida

Year: 2025

Type: article

Abstract: Introduction. The aim of this study was to analyze the sonographic findings in open spina bifida detected in the first and second trimesters of pregnancy and to correlate them with the morphopathological aspects. Materials and method. This retrospective research was conducted using data collected from fetuses who underwent anatomical ultrasound scans in the first trimester (FT) and second trimester (ST) at the Prenatal Diagnostic Unit of the Craiova County Emergency Clinical Hospital, Romania, between January 2018 and December 2023. Results. The study included 12 cases of spina bifida (SB) in the first trimester and two cases in the second trimester. We included these cases into different categories, by the type of spina bifida encountered: 12 cases of SBA-FT, which included eight cases of myeloschisis (MYS), three cases of myelomeningocele (MMC) and one case of meningocele (ME); and two cases of SBA-ST of the MYS type. We also included five control cases of first-trimester miscarriages without structural abnormalities, in order to compare structural aspects. In the SB-FT group, we found abnormal aspects of the fourth ventricle, also named intracranial translucency (IT) in 9 out of 12 cases (75%), a brain stem anteroposterior diameter, and brain stem to occipital bone ratio abnormal in all 12 cases (greater than 1). The “crash sign” was present in 10 out of 12 cases (83.33%), and the spinal defect was visualized in 8 out of 12 patients (66.66%). In the SB-ST group, using the standard axial sections (transventricular, transcerebellar, transthalamic and a longitudinal and transverse section through the spinal cord), we were able to detect defects and changes in the analyzed cases: frontal bone collapse, transcerebellar compression, ventriculomegaly, cisterna magna obliteration, and structural defects of the spinal cord. We observed the presence of specific known ultrasound signs such as the “lemon sign” and the “banana sign”. Medical termination of pregnancy was the option chosen in all cases of SB-FT. The two cases of SB-ST resulted in miscarriage. This allowed us to conduct an extensive histologic study in order to confirm the ultrasonographic diagnosis. Conclusions. The ultrasonographic visualization of the spinal defect along with the examination of both medio sagittal and axial planes looking for intracranial ultrasonographic markers are important in the early detection of spina bifida.

Source: Ginecologia ro

DOI: 10.26416/gine.47.1.2025.10584