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Assessment of fetal brain abnormalities
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Cranium bifidum is classified into four types of encephaloschisis (including anencephaly and exencephaly), meningocele, encephalomeningocele, encephalocystocele, and cranium bifidum occultum. Encephalocele occurs in the occipital region in 70% to 80%. Acrania, exencephaly, and anencephaly are not independent anomalies. It is considered that dysraphia (absent cranial vault, acrania) occurs in very early stage and disintegration of the exposed brain (exencephaly) during the fetal period results in anencephaly. Encephalocele (Fig. 3) is often observed in the median section and in the parieto-occipital part. ABS should be differentiated from acrania during early pregnancy, because ABS has completely different pathogenesis from acrania/exencephaly. In cases of ABS, cranial destruction occurs secondary to an amniotic band; similar appearance is often observed.
Fetal malformations detected with magnetic resonance imaging in the diabetic mother
Published in Moshe Hod, Lois G. Jovanovic, Gian Carlo Di Renzo, Alberto de Leiva, Oded Langer, Textbook of Diabetes and Pregnancy, 2018
Neural tube is a primitive bundle of nerves that folds to form brain at the front end and spinal cord at the rear end. Failure of this structure to close on the 28th conception day results in a broad spectrum of NTDs. Anencephaly and spina bifida are the most common variants of NTD. The former begins with maldevelopment of the skull (acrania) with protrusion of the brain (exencephaly). The brain is then destroyed by its exposure to amniotic fluid.
Prolonged Pregnancy
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Dhammike Silva, Dilip Visvanathan, Sujatha Thamban
Anencephaly can now be diagnosed from 11 weeks. In the early stage, there is acrania. Here the vault of the skull is missing but the forebrain is intact. This may progress to exencephaly, which is herniation of the forebrain. Amniotic fluid erodes the forebrain, leading to anencephaly. At scan, it will not be possible to obtain a BPD measurement, as the cranial vault is symmetrically absent (Fig. 6). The orbits are more pronounced, giving a frog’s eye appearance. There is a 50 per cent risk of associated lower spinal cord defect. An omphalocoele may also be present. The liquor volume may be increased and fetal movements may be marked.
Prenatal diagnosis of cystic hygroma cases in a tertiary centre and retrospective analysis of pregnancy results
Published in Journal of Obstetrics and Gynaecology, 2022
Sureyya Saridas Demir, Erkan Cagliyan, Derya Öztürk, Samican Özmen, Sabahattin Altunyurt, Tufan Çankaya, Elcin Bora
The universe of the study consists of 29 live foetuses with cystic hygroma septation on the foetal neck only in the first or second trimester (between the 11th and 20th weeks of pregnancy) who applied to our tertiary centre. Prenatal USG examinations were performed by an experienced perinatologist and his team using Voluson p6 and E8 (GE Healthcare, Chicago, IL) USG devices in the perinatology department. The diagnosis of foetal cystic hygroma was made according to the increased nuchal translucency (NT) (95th percentile for CRL) according to the images taken from transverse and mid-sagittal sections of the foetal neck on USG (Figures 1 and 2). In the study, molar pregnancy, ectopic pregnancy, neural tube defect, acrania and encephalocele diagnoses were accepted as exclusion criteria.
Combined Use of Magnesium Sulfate and Fingolimod for Antenatal Neuroprotection against Inflammation-Mediated Experimental Preterm Brain Injury in a Rat Model
Published in Fetal and Pediatric Pathology, 2022
Serenat Eris Yalcin, Mekin Sezik, And Yavuz, Mehtap Savran, Halil Asci, Ozlem Ozmen
Although the 0.5 mg/day dose of fng approved by the US Federal Drug Administration for use in patients with MS has been deemed generally safe, bradycardia, atrioventricular block, macular edema, increased serum liver enzyme levels, and recurrent herpes infections have been reported in long-term and high-dose use [16]. Concerns have also been raised regarding the potential teratogenicity of fng. Karlsson and his colleagues reported abnormal fetal development (unilateral posteromedial bending, acrania, tetralogy of Fallot, fetal death, and fetal growth restriction) in five cases after use in the first trimester in a series of 66 cases [17]. However, the prevalence of major congenital malformations following fng exposure during pregnancy (2.3%–3%) appears to be comparable with that of the general population [18]. There were no reports of fetal anomalies or fetal loss with use in the second and third trimesters. Based on these findings, using fng in the third trimester, as we did in our current study, appears to be relatively safe in human pregnancies because there is no solid evidence of teratogenicity during use in the second half of pregnancy.
Investigation of copeptin levels in foetal congenital central nervous system anomalies
Published in Journal of Obstetrics and Gynaecology, 2021
Gestational age is a very important parameter for normal ultrasound appearance of the CNS. For example, the corpus callosum cannot be detected at 14 weeks of gestation because these structures appear after the 18–20th week of gestation (Balakumar 2004). On the other hand, the other technical factors that may cause inadequate ultrasound images are poor foetal position, obesity and oligohydramnios, so early detection of CNS by a non-invasive highly sensitive biomarker becomes important. Syngelaki et al. documented in their series of 44,859 cases that 100% of acrania and allobar holoprosencephaly could be diagnosed at 11–13 weeks of gestation. However, none of the case of corpus callosum agenesis, semilobar holoprosencephaly, and cerebellar or vermian hypoplasia, could be diagnosed in the first trimester (Syngelaki et al. 2011). Dane and colleagues found that 10 of 17 patients who had first trimester foetal anomaly had cranial anomaly and Grande et al showed that only 53% of the central nervous system anomalies can be diagnosed by ultrasonographic examination performed between the 11th and 14th gestational weeks (Dane et al. 2007; Grande et al. 2012).