Proportion of Central Nervous System Fetal Malformations in patients attending Fetomaternal Unit Minia University as an observation study

Abstract

Background: Central nervous system (CNS) anomalies are the most serious congenital abnormalities. Ultrasound examination is an effective and non-invasive modality for prenatal diagnosis of these anomalies. The objectives of this study were to detect the proportion of C.N.S malformations in patients attending the feto-maternal unit at Minia University and analyze the related factors at 22nd to 28th weeks of gestation and detect the diagnostic accuracy of Ultrasound in the diagnosis of CNS malformations. Methods: This is a prospective study that was conducted on 100 women who were referred to Fetomaternal Unit at Minia University for any C.N.S anomalies, in the period between September 2019 and September 2020. Results: 35% of cases had a family history of congenital fetal malformations and 8% of cases had a family history of C.N.S fetal malformations. 42% of cases had a history of aneuploidy and 46% of cases had a history of congenital infections. Conclusion: Dimensional ultrasonography is useful in detecting and diagnosing some fetal central nervous system abnormalities. However, owing to the location of the fetus, some defects may be difficult to identify with two-dimensional ultrasonography. For example, while acquiring the median plane with 2D transabdominal ultrasonography is difficult and requires specific competence in transvaginal transfontanelle scanning, it is often regarded as a good preliminary diagnosis tool for screening for fetal defects.

Prevalence of neurological fetal anomalies diagnosed by ultrasonography in Sohag governorate

“…Hassan et al (2022) (9) reported that, as regarding ultrasound detected CNS anomalies in 79 fetuses. The most common anomaly detected wasVentriculomegaly that found in 22%.…”

“…It is important to determine whether the CNS structures present complex embryology and anatomy because the CNS undergoes most of its changes during gestation. CNS changes are associated with changes in the US aspects of the CNS during gestation (9) . Therefore, every professional involved in the fetal evaluation should be aware of the embryology and anatomy of CNS as well as of its ultrasound characteristics of different gestational ages to avoid diagnostic errors (9) .…”

“…CNS changes are associated with changes in the US aspects of the CNS during gestation (9) . Therefore, every professional involved in the fetal evaluation should be aware of the embryology and anatomy of CNS as well as of its ultrasound characteristics of different gestational ages to avoid diagnostic errors (9) .…”

“…So, it is important to emphasize that abnormal CNS assessment in the second-trimester morphology scan does not exclude the emergence of fetal alterations during pregnancy, hence it's necessary to re-evaluate the fetal brain morphology throughout pregnancy (10) . Conventionally, the ultrasound evaluation of brain development during pregnancy is performed in the axial planes of the fetal skull; however, that type of evaluation has some limitations (9) .…”

“…According to Hassan et al (2022) (9) who aimed to detect the proportion of C.N.S malformations in patients attending the fetomaternal unit at Minia University. The study reported that 25% of cases had a previous history of congenital fetal malformations, and 6% of cases had a previous history of C.N.S fetal malformations.…”