Functional motor outcome in children with myelomeningocele: correlation with anatomic level on prenatal ultrasound

Area of Science:

• Pediatric neurology
• Fetal surgery
• Medical imaging

Background:

• Myelomeningocele is a severe birth defect.
• Accurate prognosis is crucial for prenatal counseling.
• Predicting functional outcomes remains challenging.

Purpose of the Study:

• To evaluate the predictive accuracy of prenatal ultrasound findings for myelomeningocele.
• To correlate prenatal anatomic level with neuromotor and functional motor outcomes.
• To assess the utility of high-resolution ultrasound in prenatal counseling for myelomeningocele.

Main Methods:

• Follow-up of 15 children with prenatally diagnosed myelomeningocele for at least three years.
• Correlation analysis between prenatal ultrasound-visualized anatomic level, radiographic level, and neuromotor level.
• Assessment of functional motor outcome in relation to prenatal and birth-level assessments.

Main Results:

• Prenatal anatomic level on high-resolution ultrasound accurately predicted neuromotor level and functional motor outcome in 12 out of 15 children.
• Prenatal anatomic level was a more reliable predictor of motor outcome than the motor level assessed at birth.
• High-resolution ultrasound provided valuable insights into the potential long-term functional status.

Conclusions:

• High-resolution ultrasound is a valuable tool for predicting functional motor outcomes in prenatally diagnosed myelomeningocele.
• Prenatal anatomic level visualized on ultrasound can guide discussions on motor prognosis with families.
• This imaging modality can enhance prenatal counseling and management strategies for myelomeningocele.