RESUMEN
Suggested management flowchart in presence of a prenatal diagnosis of open spina bifida.
Asunto(s)
Espina Bífida Quística , Disrafia Espinal , Embarazo , Femenino , Humanos , Estudios Retrospectivos , Disrafia Espinal/diagnóstico por imagen , Disrafia Espinal/cirugía , Espina Bífida Quística/diagnóstico por imagen , Espina Bífida Quística/cirugía , Diagnóstico Prenatal , Feto/diagnóstico por imagen , Feto/cirugía , Ultrasonografía PrenatalRESUMEN
OBJECTIVE: To evaluate brain biometry and cortical development by neurosonography in fetuses with congenital heart defect (CHD) and evaluate differences among different type of CHD. METHODS: In a prospective cross sectional study singleton fetus with CHD were matched with controls and grouped into two categories according to the predicted severity of cerebral arterial oxygen deficit induced by the CHD: Group A mildly reduced or normal and Group B moderately to severely reduced. Neurosonography was done at 30-33 weeks to obtain measurements of corpus callosum (CC), cerebellar vermis (CV), Sylvian fissure (SF) insula, parieto-occipital fissure (POF), and calcarine sulci fissures (CSF). All the neurosonographic parameters were adjusted by head circumference (HC). RESULTS: A total of 78 fetuses with CHD (group A 30; group B 48) and 80 matched controls form uncomplicated pregnancies were considered. CHD fetuses have significantly smaller CC, CV, SF, and POF and bigger insula when compared to control fetuses. These differences are more marked in group B fetuses. These differences remained significant after correction for HC values. CONCLUSION: Fetuses with CHD have an impaired cortical development and these variations are more evident in those with a predicted lower oxygen delivery to the brain.
Asunto(s)
Cardiopatías Congénitas , Embarazo , Femenino , Humanos , Estudios Transversales , Estudios Prospectivos , Cardiopatías Congénitas/diagnóstico por imagen , Cardiopatías Congénitas/complicaciones , Encéfalo , Feto , Biometría , Arteria Cerebral Media/diagnóstico por imagen , Ultrasonografía Prenatal , Oxígeno , Desarrollo Fetal , Edad GestacionalRESUMEN
OBJECTIVES: To assess cerebral growth and the development of fetal cortex using neurosonography in fetuses from pregnancies experiencing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) according to infection timing. METHODS: Pregnancies with by SARS-CoV-2 during first and second trimesters were prospectively studied and matched with unaffected controls. Enclosed women underwent neurosonography at 30-34 weeks of gestation and corpus callosum (CC) and cerebellar vermis (CV) lengths measured. Further Sylvian fissure (SF), insula. Parieto-occipital fissure (POF), and calcarine sulci fissures (CSF) depths were obtained. The ultrasonographic variables considered were normalized with fetal head size. RESULTS: One hundred and seventy four consecutive pregnancies experiencing SARS COV 2 infection (81 before 14 weeks and 93 later) and 131 not affected pregnancies were considered. General and pregnancy characteristics were similar between the three groups of women. No significant differences existed in CC and CV lengths across groups. Similarly, insula, SF, POF And CSF depth did not result changed in fetuses of affected mothers. CONCLUSIONS: SARS-CoV-2 infection does nor resulted associate with differential fetal cortical development or brain growth in mildly symptomatic pregnant women. This information may be useful to reassure infected mothers on the health of their fetuses.