Posterior brain in fetuses with open spina bifida at 11 to 13 weeks

Robert Lachmann1, Rabih Chaoui, Jose Moratalla

  • 1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.

Prenatal Diagnosis
|December 29, 2010
PubMed

Insights

First-trimester fetuses with open spina bifida (OSB) show significant posterior brain abnormalities. Measurements reveal altered brain stem and occipital bone dimensions, indicating early developmental issues.

Area of Science:

  • Fetal Medicine
  • Developmental Biology
  • Neurology

Background:

  • Open spina bifida (OSB) is a complex congenital condition.
  • Early detection of OSB-related abnormalities is crucial for management.
  • Posterior fossa development is critical in early gestation.

Purpose of the Study:

  • To quantify posterior fossa structural changes in fetuses with OSB during the first trimester.
  • To establish normative data for posterior fossa measurements in early pregnancy.
  • To identify specific biometric markers for OSB in first-trimester fetuses.

Main Methods:

  • Retrospective analysis of stored mid-sagittal fetal facial images.
  • Measurement of brain stem diameter and brain stem to occipital bone (BSOB) diameter.
  • Comparison of measurements between 30 fetuses with OSB and 1000 normal controls at 11-13 weeks gestation.

Main Results:

  • In controls, brain stem and BSOB diameters increased with crown-rump length (CRL), while the brain stem to BSOB ratio decreased.
  • Fetuses with OSB exhibited significantly enlarged brain stem diameters (above 95th percentile in 96.7%).
  • Fetuses with OSB showed reduced BSOB diameters (below 5th percentile in 86.7%) and an elevated brain stem to BSOB ratio (above 95th percentile in 100%).

Conclusions:

  • Measurable posterior brain abnormalities are prevalent in fetuses with OSB as early as 11-13 weeks gestation.
  • Specific biometric alterations in the posterior fossa can serve as early indicators of OSB.
  • These findings highlight the potential for early ultrasound screening for OSB.
Abstract

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