First trimester supratentorial and infratentorial abnormalities in fetuses with open spina bifida. (3rd July 2021)

• Record Type: Journal Article
• Authors: Acuna, Joann; Lau, Gregory; Rad, Steven; Kim, Matthew; Gornbein, Jeffrey; Zoppi, Maria; Monni, Giovanni; Rotmensch, Siefried; Solt, Ido
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 34:Number 13(2021)
• Page Start: 2159
• Page End: 2165
• Publication Date: 2021-07-03
• Subjects: First-trimester -- infratentorial -- prenatal diagnosis -- spina bifida -- supratentorial; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2019.1659772
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objectives: To examine whether supratentorial, infratentorial, and calvarial manifestations of open spina bifida (OSB) occur in the first-trimester. Methods: Supratentorial (midbrain curvature, thalamic height), infratentorial (fourth ventricle diameter, brain-stem diameter [BSD], ratio of BSD to BSD-occipital bone diameter [BSOB]), and calvarial (frontomaxillary facial [FMF] angle) parameters were measured in stored midsagittal facial images at 110–136 weeks of 500 normal and 10 open spina-bifida fetuses by 3 blinded examiners. Results: OSB fetuses displayed a larger midbrain curvature (93.26 ± 6.97 versus 97.79 ± 10.04, p < .05), decreased FMF angle (84.10 ± 5.44 versus 78.46 ± 5.82, p < .001), smaller fourth ventricle diameter (0.25 ± 0.04 mm versus 0.18 ± 0.05 mm, p < .001), smaller BSD (0.29 ± 0.04 mm versus 0.23 ± 0.04 mm; p < .001), and increased BSD to BSOB ratio (0.64 ± 0.71 versus 0.73 ± 0.93, p < .03) than normal controls, respectively. Thalamic height was not significantly altered. Detection rates of OSB were highest for fourth ventricle diameter and FMF angle (60% and 40%, respectively, at 95% specificity). BSD, BSD to BSOB ratio, midbrain curvature yielded sensitivities of 30% with 95% specificity. Two-dimensional discrimination for pairs of measures combining fourth ventricle diameter with FMF angle increased sensitivity to 90% with specificity of 90.7%. Conclusions: Our findings suggest that supratentorial, infratentorial, and calvarial changes consistent with the Chiari-II malformation are already established in first-trimester fetuses with OSB.