Prenatal diagnosis of spina bifida: from intracranial translucency to intrauterine surgery.

摘要: Accurate and timely prenatal diagnosis of spina bifida (SB) is a major goal modern antenatal care. Prenatal screening for open SB should be first performed at the time routine first-trimester ultrasound by examining posterior fossa obliteration or non-visualization fourth ventricle ("intracranial translucency") cisterna magna. The second step second-trimester anatomy scan, which features Chiari type II malformation looked for, including ventriculomegaly, scalloping frontal bones ("lemon" sign), backward caudal displacement cerebellar vermis with magna ("banana" sign). In cases positive findings, evaluation must include focused examination spine defects. closed occulta, cranial will not present as they are associated leaking spinal fluid resultant hindbrain herniation, highlighting fact that examined thoroughly whenever possible during scan. tertiary fetal medicine centers, two-dimensional three-dimensional allows an accurate determination location, type, extent, upper level defect well presence anomalies. Fetal magnetic resonance imaging restricted to candidates intrauterine surgery part preoperative protocol.