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[Poor prognosis in children with ultrasonographically diagnosed abnormalities of the central nervous system]
Insights
Long-term follow-up revealed a poor prognosis for children with central nervous system malformations diagnosed prenatally. Mild hydrocephaly cases showed a potentially better outcome.
Area of Science:
- Neuroscience
- Pediatrics
- Medical Imaging
Background:
- Prenatal diagnosis of central nervous system (CNS) malformations presents significant challenges for predicting long-term outcomes.
- Understanding the developmental trajectory of affected children is crucial for clinical management and parental counseling.
Purpose of the Study:
- To conduct a long-term follow-up of children diagnosed with central nervous system malformations during the prenatal period.
- To evaluate the developmental outcomes and survival rates in this cohort.
Main Methods:
- A descriptive study was conducted evaluating ultrasound examinations from 1985 to 1990.
- High-risk pregnancies and suspected fetal malformations prompted specialized prenatal ultrasound.
- Pediatricians and general practitioners provided follow-up data for surviving children.
Main Results:
- Out of 67 fetuses with prenatal CNS malformations, only 7 survived beyond one month.
- Two survivors developed normally, one died after several years, and four had severe developmental retardation.
- The two children with normal development both presented with mild hydrocephaly.
Conclusions:
- The overall prognosis for children with prenatally diagnosed CNS malformations is generally poor.
- Mild hydrocephaly may be associated with a more favorable prognosis in this population.
Objective:
Long-term follow-up of children with a prenatally diagnosed malformation of the central nervous system.
Design:
Descriptive study.
Setting:
Department of prenatal diagnosis, Academic Medical Center, Amsterdam, the Netherlands.
Methods:
Evaluation of all documented ultrasound examinations between 1985 and 1990 (6 years). These ultrasound examinations were performed in women with an increased risk for a foetal malformation, because of obstetrical complications or when a foetal malformation was suspected on ultrasound examination performed elsewhere. Paediatricians and general practitioners were asked to provide follow-up data on the children who were still alive.
Results:
Seven out of 67 foetuses with a prenatally diagnosed malformation of the central nervous system lived longer than one month. Two out of these 7 children developed normally, one child died after several years and four children were severely retarded. The two children who developed normally both had mild hydrocephaly.
Conclusion:
Prognosis of children with a prenatally diagnosed malformation of the central nervous system is poor. Children with mild hydrocephaly may have a better prognosis.