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Long-Term Outcomes of Prenatally Diagnosed Fetal Hemivertebra: A 15-Year Single-Center Review
Tatiana Costas1,2,3, María de la O Rodríguez1,2,3, María Martín Esquilas1,3
1Department of Obstetrics and Gynecology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain.
Insights
Prenatal diagnosis of fetal hemivertebrae is feasible. Multiple hemivertebrae are linked to associated anomalies and poorer outcomes, while isolated cases show normal childhood development.
Area of Science:
- Prenatal diagnosis
- Fetal anomalies
- Pediatric development
Background:
- Hemivertebrae are congenital vertebral malformations.
- Prenatal detection is crucial for management.
- Associated anomalies impact prognosis.
Purpose of the Study:
- Describe prenatal hemivertebrae cases.
- Assess associated malformations.
- Evaluate pregnancy and child development outcomes.
Main Methods:
- Prospective observational study (2007-2022).
- N=10 cases of prenatally diagnosed hemivertebrae.
- Postnatal follow-up via interviews and records.
Main Results:
- Most diagnosed in second-trimester ultrasound; lumbar region most affected.
- 40% had multiple hemivertebrae, often with other anomalies.
- Isolated single hemivertebrae showed favorable outcomes.
Conclusions:
- Prenatal diagnosis of hemivertebrae is achievable and clinically relevant.
- Hemivertebrae often associate with genetic syndromes and other disorders.
- Prognosis depends on associated anomalies and extent of vertebral involvement.
Background/Objectives:
The primary aim of this study was to describe all cases of fetal hemivertebrae diagnosed prenatally at the Hospital Clínico Universitario de Salamanca over the last 15 years. Additionally, the presence of associated malformations was assessed, pregnancy outcomes were evaluated, and child development results were analyzed in affected cases.
Methods:
We undertook a prospective observational analysis of all cases (N = 10) of prenatally diagnosed hemivertebrae at our hospital between 2007 and 2022. Postnatal follow-up was performed through telephone interviews and reviewing medical records.
Results:
Most cases were diagnosed during the second-trimester ultrasound, with the lumbar region being the most frequently affected site (60%). Multiple hemivertebrae were detected in 4 of 10 cases. One case of Marfan syndrome and two cases of VACTERL association (vertebral defects, anal atresia, tracheoesophageal fistula, renal dysplasia, and limb abnormalities) were documented. Six cases presented with additional malformations. Cases involving multiple hemivertebrae (40%) were more likely to be associated with other anomalies and poorer prognoses, while isolated single hemivertebra showed favorable outcomes, with normal development during childhood. Vaginal delivery occurred in six cases, while cesarean sections were performed for standard obstetric indications unrelated to the hemivertebra diagnosis.
Conclusions:
Prenatal diagnosis of hemivertebra is achievable and holds critical neonatal and postnatal relevance. Hemivertebrae are often linked to additional disorders, including genetic syndromes, and carry significant prognostic implications depending on the associated anomalies and the extent of vertebral involvement.
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