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The dynamic fetal brain.

Dena Towner1, John McGahan, Laila Rhee-Morris

  • 1Department of OB/GYN, University of California Davis Medical Center, 4860 Y Street, Sacramento, CA 95817, USA.

Journal of Clinical Ultrasound : JCU
|April 6, 2007
PubMed
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Fetal brain development can change significantly. Even with a normal second-trimester ultrasound, later scans are crucial for detecting new intracranial abnormalities like hydrocephalus or hemorrhage.

Area of Science:

  • Medical Imaging
  • Fetal Medicine
  • Neurology

Background:

  • Routine second-trimester fetal ultrasounds are vital for assessing intracranial anatomy.
  • Normal findings in the midtrimester do not always predict a healthy fetal brain throughout gestation.

Purpose of the Study:

  • To investigate the development of intracranial abnormalities in fetuses initially showing normal anatomy in the second trimester.
  • To characterize the types of pathology that can arise between the second and third trimesters.

Main Methods:

  • Sonographic examination of 6 fetuses with initially normal second-trimester head ultrasounds.
  • Follow-up sonography in the third trimester to identify evolving intracranial abnormalities.

Main Results:

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  • Identified four categories of intracranial pathology: obstructive hydrocephalus, intraventricular hemorrhage, non-intraventricular hemorrhage, and porencephaly.
  • Demonstrated that significant intracranial pathology can develop de novo after a normal midtrimester assessment.

Conclusions:

  • A normal second-trimester fetal intracranial examination is not definitive.
  • Subsequent sonographic evaluations are necessary to detect developing fetal brain pathologies.
  • Spontaneous development of significant intracranial abnormalities can occur later in pregnancy.