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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.
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.
Objective:
To measure the changes in the posterior fossa in first-trimester fetuses with open spina bifida (OSB).
Methods:
The brain stem diameter and brain stem to occipital bone (BSOB) diameter were measured in stored images of the mid-sagittal view of the fetal face at 11(+0) to 13(+6) weeks from 30 fetuses with OSB and 1000 normal controls.
Results:
In the control group, the brain stem and BSOB diameter increased significantly with crown-rump length (CRL) and the brain stem to BSOB ratio decreased. In the spina bifida group, the brain stem diameter was above the 95th percentile of the control group in 29 (96.7%) cases, the BSOB diameter was below the 5th percentile in 26 (86.7%) and the brain stem to BSOB ratio was above the 95th percentile in all cases.
Conclusions:
At 11 to 13 weeks the majority of fetuses with OSB have measurable abnormalities in the posterior brain.
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