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Updated: Dec 14, 2025
Murine Fetal Echocardiography
Published on: February 15, 2013
Fetal Open and Closed Spina Bifida on a Routine Scan at 11 Weeks to 13 Weeks 6 Days
Yimei Liao1, Huaxuan Wen1, Guoyang Luo2
1Department of Ultrasound and Central Laboratory, Shenzhen Maternity and Child Healthcare Hospital, First School of Clinical Medicine, Southern Medical University, Shenzhen, China.
Insights
First-trimester scans effectively screen for open spina bifida (OSB), with an obliterated cisterna magna (CM) being a key indicator. However, detection of closed spina bifida (CSB) remains challenging in early pregnancy.
Area of Science:
- Prenatal Diagnosis
- Fetal Medicine
- Medical Imaging
Background:
- Spina bifida (SB) is a complex neural tube defect.
- Early detection of SB is crucial for appropriate management and counseling.
- First-trimester ultrasound markers are being investigated for improved screening.
Purpose of the Study:
- To assess the sensitivity of routine first-trimester scans for detecting spina bifida (SB).
- To evaluate the utility of first-trimester intracranial signs in SB screening.
- To determine the detection rates for open spina bifida (OSB) and closed spina bifida (CSB).
Main Methods:
- Retrospective review of a prospectively collected database of SB cases (2008-2015).
- Analysis of ultrasound images and medical records for diagnosed SB cases.
- Confirmation of prenatal diagnoses with birth or autopsy findings.
Main Results:
- The study identified 24 SB cases out of 53,349 pregnancies.
- First-trimester detection rate for OSB was 100% (7/7), while for CSB it was 28.5% (2/7).
- An obliterated cisterna magna (CM) demonstrated high sensitivity but low specificity for OSB.
Conclusions:
- Routine first-trimester ultrasound scans show high sensitivity for screening open spina bifida (OSB).
- The cisterna magna (CM) appears to be the most sensitive intracranial sign for OSB detection.
- Screening for closed spina bifida (CSB) in the first trimester requires further investigation.
Objectives:
This study aimed to determine the sensitivity of a first-trimester routine scan in detecting spina bifida (SB) and evaluating the first-trimester intracranial signs.
Methods:
This retrospective study was a review of a prospectively collected database. All cases of SB diagnosed in a tertiary center from 2008 to 2015 were identified. The ultrasound images and medical records were reviewed. All cases of SB diagnosed prenatally were confirmed at birth or autopsy.
Results:
A total of 24 cases of SB were diagnosed from 53,349 pregnancy cases. Except for 10 cases with a body stalk anomaly, craniorachischisis, or iniencephaly, 7 cases with open spina bifida (OSB) and 7 cases with closed spina bifida (CSB) were analyzed. The first-trimester detection rates were 100% (7 of 7) for OSB and 28.5% (2 of 7) for CSB. Eight cases were highly suspected of SB in the first trimester because of an abnormal appearance of the posterior brain; 3 were false-positive cases. Two isolated cases of OSB had first-trimester intracranial signs. An obliterated cisterna magna (CM) showed the highest sensitivity for OSB but low specificity. Two cases of OSB had no discernible landmark of intracranial translucency and the CM, and 4 showed normal intracranial translucency with an obliterated CM. All CSB cases were coupled with a normal hind brain except for 2 cases.
Conclusions:
A first-trimester routine scan has high sensitivity in screening for OSB. The CM may be the most sensitive intracranial sign.
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