Pregnancy Clinical Trial
Official title:
Fetal Spina Bifida -Prenatal Course and Outcome in 103 Cases A Single Center Experience.
Neural tube defects are one of the most prevalent congenital abnormalities, surpassed only by
cardiac malformations. Spina bifida accounts for the majority of the neural tube defects and
is comprised of a wide spectrum of anomalies ranging from small isolated sacral dysraphisms
to large spinal defects. The origin of spina bifida is a failure of neurulation. It usually
occurs at 15 days post-conception, resulting in a bony spinal defect with extrusion of the
neural placode and/or the meninges outside of the spinal canal. Spina bifida has a prevalence
of 1-5 in 1,000 live births and is the most complex congenital abnormality compatible to
long-time survival. Concerning psychomotor development as well as urinary bladder and
intestinal morbidity the prognosis ranges from normal functional outcome to severe
disability.
The diagnosis of serious fetal abnormalities such as spinal dysraphism by ultrasound
screening allows patients to prepare for the birth of an impaired child or to consider
termination of the pregnancy. In current practice, prenatal counseling and obstetric
management depend not only on the detection of a spinal dysraphism but also on an appropriate
assessment of the severity of the defect and its possible impact on the postnatal development
of the affected child.
Level and type of lesion, presence of associated anomalies (e.g., Chiari II malformation and
ventriculomegaly) and mode of surgical closure are factors known to have prognostic impact on
the postnatal outcome. Previous studies reported that postnatally determined lesion levels
correlated well with functional status and survival. On the contrary, it is still not clear
whether similar data obtained antenatally are of value.
In this study, the investigators will review their database of all cases of prenatally
diagnosed spina bifida within a 16 year period between 1993 and 2009. By analyzing the
prenatal and postnatal characteristics of fetuses with spina bifida in relation to the
anatomic level of the lesion, the investigators aim to contribute further information
regarding the natural course of affected pregnancies and the correlation of prenatal
ultrasound findings with their functional outcome.
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