Fetal head shape in spina bifida in the second trimester.

Area of Science:

• Prenatal diagnosis
• Fetal medicine
• Medical imaging

Background:

• Spina bifida is a complex neural tube defect with significant long-term implications.
• Early detection of fetal anomalies is crucial for timely intervention and management.
• Ultrasonography is a primary tool for prenatal screening and diagnosis.

Purpose of the Study:

• To identify and describe a specific ultrasonographic finding indicative of potential spina bifida.
• To highlight the significance of anterior cranial narrowing in the absence of oligohydramnios as a warning sign.
• To emphasize the need for comprehensive fetal assessment upon detecting this anomaly.

Main Methods:

• Retrospective analysis of second-trimester fetal ultrasound examinations.
• Identification of cases with anterior cranial narrowing near the coronal sutures.
• Exclusion of cases with oligohydramnios.
• Correlation of ultrasonographic findings with confirmed diagnoses.

Main Results:

• Unequivocal anterior cranial narrowing, particularly around the coronal sutures, was observed as a potential marker.
• This finding, in the absence of oligohydramnios, was associated with an increased risk of spina bifida.
• The presence of this cranial anomaly prompted further detailed examination of the fetal spine and cerebellum.

Conclusions:

• Anterior cranial narrowing without oligohydramnios serves as a critical warning sign for spina bifida in the second trimester.
• This ultrasonographic feature mandates a thorough evaluation of the fetal spine, cerebellum, and other relevant structures.
• Amniocentesis may be considered for genetic assessment and further diagnostic confirmation.