Indirect ultrasonographic markers in the spina bifida diagnostic without associated genetic syndromes during the second trimester of pregnancy

C. Berceanu, M.M. Cirstoiu, E. Bratila, R. Ciortea, S. Berceanu, S. Vladareanu

Rezumat: Introduction. Spina bifida is a non-lethal foetal anomaly, but the prognostic, the evolution and life quality of the foeti born with this malformation implies limb paralyses, severe neuro-motor dysfunctions, urinary and fecal incontinence etc. The cranial and cerebral ultrasound signs in the spina bifida aperta have a sensibility of over 99%, being sometimes the first element which draws the attention on a possible defect of the neural tube. The study evaluates the indirect cerebral and cranial signs, for the spina bifida aperta diagnostic without as sociated genetic syndromes, during the second trimester of pregnancy. Material and method. The thesis analyses a number of 17 cases diagnosed with spina bifida aperta, in three prenatal diagnostic centres, in two years’ time, 2013-2014. The ultrasonographic examination was performed by ob serving the ISUOG guides for the foetal neurosonography. The ultrasonographic signs and the parameters included in the stu dy were: the biparietal diameter, the cranial circumference, the flattening of the frontal bones, the transverse cerebellar com pression, the ventriculomegaly, the obliteration of the cis terna magna. The foetal karyotype was performed in all ca ses. Results. Spina bifida aperta in the cases with normal foe tal karyotype. The sign of fruits: 94.11%. The CM obliteration: 88.23%. The ventriculomegaly: 70.58%. The decrease of BPD: 64.7%. Low cranial circumference: 41.17%. Cerebellar anomaly on the whole - 16 cases. The therapeutic interruption of the preg nancy was performed in 16 cases, 1 case evolved on term with the informed counselling of the parents. Conclusions. The secondary ultrasound markers represent indirect diagnostic ele ments, but many times very precise in spina bifida aperta. The sign of fruits or the ventriculomegaly are in many cases the first ele ment which draws the attention on the ultrasound screening in the second trimester of pregnancy. The ultrasound 3D/4D be come almost indispensable for the foetal neurosonography.
Cuvinte cheie: fruit findings, ventriculomegaly, spina bifida, screening.