Prenatal diagnosis of closed spina bifida: multicenter case series and review of the literature

Hérbene José Figuinha Milani, Enoch Quinderé de Sá Barreto, La Hong Chau, Nguyen Ha To, Antonio Fernandes Moron, Simon Meagher, Fabricio Da Silva Costa, Edward Araujo Júnior

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12 Citations (Scopus)

Abstract

Objective: Closed spina bifida (CSB) is an abnormality of the posterior arch formation in which the defect is covered by the skin, without protrusion of nervous tissue. The prenatal diagnosis of CSB is very difficult, rarely diagnosed antenatally. Methods: We present a multicenter case series of six prenatal diagnosis of CSB using two-dimensional (2D) ultrasonography complemented with three-dimensional (3D) ultrasonography and magnetic resonance imaging (MRI). All cases of prenatal diagnosis of CSB were confirmed in the postnatal period/termination of pregnancy by both clinical and/or imaging diagnosis (ultrasonography and MRI). Results: 2D ultrasonography allowed the prenatal diagnosis of six cases. We observed two cases of subcutaneous lipomas, two cases of meningoceles, one case of fibrolipomas, and one case of false-positive CSB (meningomyelocele). 3D ultrasonography using rendering mode was important in one case of meningocele (case# 3). Three cases were delivered at term and one of them was submitted to corrective surgery. All these three newborns were discharged from the hospital well and without neurologic signs. Termination of pregnancy was performed in three cases. Conclusion: During prenatal evaluation, detailed ultrasonographic assessment of the entire spine with the identification of the position and morphology of the conus medullaris and absence of cranial signs of spinal dysraphism are the most valuable sonographic clues for the diagnostic of the CSB.

Original languageEnglish
Pages (from-to)736-742
Number of pages7
JournalThe Journal of Maternal-Fetal and Neonatal Medicine
Volume33
Issue number5
DOIs
Publication statusPublished - 3 Mar 2020

Keywords

  • Closed spina bifida
  • lipoma
  • meningocele
  • prenatal diagnosis

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