Fetal Advanced Neurosonography in the First Trimester of Pregnancy

Area of Science:

• Medical Imaging
• Prenatal Diagnosis
• Fetal Medicine

Background:

• Central nervous system malformations (CNSs) can be suspected in the first trimester.
• Early detection of CNS abnormalities is crucial for timely intervention.

Purpose of the Study:

• To evaluate the feasibility and reliability of an advanced first-trimester central nervous system (CNS) assessment.
• To determine if advanced ultrasound techniques can identify early markers for CNS abnormalities.

Main Methods:

• Prospective observational study of singleton pregnancies with crown-rump length (CRL) 60-82 mm.
• Detailed examination of fetal brain structures in axial and sagittal planes.
• Assessment included lateral ventricles, cerebellum, brain stem, and cisterna magna.

Main Results:

• Advanced CNS assessment was successfully performed in 93.5% of fetuses.
• High visualization rates for key brain structures were achieved (e.g., 100% for insula, lateral ventricles).
• Excellent intra- and interobserver agreement was confirmed, with an average increase of only 3 minutes in examination time.

Conclusions:

• Advanced first-trimester CNS assessment is feasible and reliable.
• This detailed ultrasound approach can identify early markers for CNS abnormalities.
• The technique offers good agreement and requires minimal additional scanning time.