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A normal second-trimester ultrasound does not exclude intracranial structural pathology.
G Malinger1, T Lerman-Sagie, N Watemberg
1Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Sackler, School of Medicine, Tel Aviv University, Tel Aviv, Israel. malinger@inter.net.il
Summary
A normal second-trimester ultrasound does not exclude serious fetal brain abnormalities. Further third-trimester screening may improve the detection of intracranial structural pathologies, aiding in accurate diagnosis and counseling.
Area of Science:
- Neuroimaging
- Prenatal Diagnosis
- Fetal Medicine
Background:
- Second-trimester ultrasound is a standard screening tool for fetal anomalies.
- Intracranial structural pathologies can develop or become apparent after the second trimester.
Purpose of the Study:
- To analyze prenatal diagnosis and management of fetal intracranial structural pathologies.
- To investigate cases where anomalies were detected after a normal second-trimester ultrasound.
Main Methods:
- Retrospective review of 203 central nervous system ultrasound examinations.
- Identification of 34 fetuses with normal second-trimester scans but later diagnosed abnormalities.
Main Results:
- Identified various intracranial pathologies including corpus callosum dysgenesis, ventriculomegaly, cysts, migrational disorders, and others.
- 16.7% of abnormal CNS ultrasounds occurred in fetuses with prior normal second-trimester scans.
Conclusions:
- A normal second-trimester ultrasound cannot definitively rule out significant fetal intracranial anomalies.
- Emphasizes the limitations of second-trimester sonography for brain development assessment.
- Recommends considering third-trimester ultrasound for improved diagnosis and parental counseling.