Brain Doppler abnormalities in fetuses with open spina bifida

Area of Science:

• Fetal Medicine
• Neurosonography
• Medical Imaging

Background:

• Open spina bifida (OSB) is a complex congenital condition affecting fetal development.
• Understanding fetal brain changes in OSB is crucial for management.
• Brain Doppler ultrasound can assess fetal cerebral blood flow.

Purpose of the Study:

• To characterize brain Doppler changes in fetuses diagnosed with isolated open spina bifida (OSB).
• To investigate alterations in cerebral blood flow redistribution in fetuses with OSB.
• To compare Doppler indices between fetuses with OSB and healthy controls.

Main Methods:

• Doppler ultrasound was used to measure umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR), and umbilicocerebral ratio (UCR).
• Fetuses with OSB were matched to controls without structural anomalies.
• Abnormal Doppler findings were defined by specific centile thresholds (e.g., MCA-PI <5th, UCR >95th).

Main Results:

• A significantly higher frequency of cerebral blood redistribution was observed in fetuses with OSB compared to controls (15.0% vs. 3.0%).
• Fetuses with OSB exhibited increased rates of abnormal MCA-PI (10.5%), decreased CPR (9.8%), and increased UCR (17.2%).
• Cerebral blood redistribution was more pronounced in OSB fetuses with ventriculomegaly.

Conclusions:

• A notable proportion of fetuses with isolated OSB demonstrate cerebral blood redistribution.
• These Doppler findings suggest altered fetal brain hemodynamics in the presence of OSB.
• Further research is warranted to explore the clinical implications of these Doppler changes.