Fetal nervous system ultrasound

This is an automatically translated article.

The evaluation of the fetal central nervous system is an important aspect of fetal ultrasound during the first trimester because some major malformations can easily be identified and thus information is sufficient to advise the patient. parents about pregnancy monitoring, fetal treatment options and also postpartum treatment and prognosis. Therefore, assessment of the fetal central nervous system in the prenatal period is extremely important with the main tool being fetal nervous system ultrasound.

1. What is fetal nervous system ultrasound?

Congenital central nervous system defects are a group of common malformations in the fetus, second only to heart defects. The incidence of congenital CNS malformations ranges from 1 to 2 cases per 1000 births. Such malformations are of clinical importance because they are associated with high morbidity and mortality, affect later neurocognitive and motor development, or may be passed on. lifelong proof. Therefore, it is extremely important to assess the fetal CNS during the prenatal period, to identify any changes in development and to provide appropriate advice to parents regarding follow-up. pregnancy monitoring, fetal treatment options, and postpartum prognosis.
The evaluation and diagnosis of CNS malformations in the prenatal period can be done by fetal nervous system ultrasound at any gestational age, including structural analysis of the brain and spinal cord. It is important to determine whether CNS structures are present in normal embryonic progression, underpinning the identification of malformations, abnormalities, and the identification of congenital anomalies.
Therefore, all professionals involved in the morphological evaluation of the fetal nervous system need to be familiar with the embryology and anatomy of the fetal CNS, as well as its sonographic features in these areas. different gestational ages, to avoid diagnostic errors.

2. When is an ultrasound of the fetal nervous system indicated?

The purpose of performing fetal neurologic ultrasound is to evaluate the structure of the fetal nervous system, including the evaluation of the fetal brain as well as the spine. This indication can be made at the end of the first trimester and at the beginning of the second trimester during 13-16 weeks of pregnancy. However, the best time for a later fetal nervous system ultrasound is still in the second trimester, which is after the 20th week of pregnancy. Because the results of these two ultrasounds are sometimes not ruled out. The occurrence of brain damage in the third trimester, in some cases, requires a repeat ultrasound at 28-32 weeks of gestation.
Necessary indications for fetal nervous system ultrasound include:
Having a relative with a child with psychomotor retardation or mental disability Suspicion of fetal brain or spine pathology detected in Fetal anatomy screening test Suspect dilated ventricles, cysts, or structural abnormalities in the fetal brain on fetal ultrasound There is a mismatch between the fetal skull and the fetal size (the skull is too small) or too large) There is a uterine infection (cytoplasmosis, toxoplasmosis) The fetus is severely retarded The fetus is identical Twins Having congenital developmental disorders in other organ systems such as heart, kidney, foot defects clubfoot, limb deformity, cleft lip, umbilical cord herniation,...

3. Basic assessment of fetal nervous system ultrasound

Basic fetal brain assessments are performed routinely during the second trimester with transabdominal transducers. This technique is used to screen for CNS malformations during the second and third trimesters of pregnancy in low-risk patients, with 80% sensitivity for detecting CNS malformations and CNS malformations. involves the study of the structure of the fetal brain and spine.
For a complete baseline ultrasound assessment of fetal brain morphology, scans of the skull should be performed in three sections: transthalamic, transventricular, and transcerebellar. Structures evaluated in fetal nervous system ultrasound include:
Skull: on shape and biometric indicators Brain parenchyma: on structure Lateral ventricle Choroid plexus Interspheric fissure Tentacles Cerebellum Posterior fossa

4. Detailed evaluation of fetal nervous system ultrasound

When the fetus is suspected of developing CNS malformations, coupled with the limitations of conventional fetal brain assessment, which is performed only at baseline views, Advanced Fetal Nervous System Ultrasound Tool is born
The fetal nervous system sonographer will perform a detailed ultrasound examination of the central nervous system based on the principle of multidimensional analysis of the structure brain, also through basal views obtained by positioning the transducer through the craniofacial fissures and fontanelles. For the fetus in the right position, the doctor can access it through the abdomen or through the vagina; in which, the transvaginal method offers the higher advantage that it will allow the use of a vaginal transducer at high frequencies, obtaining better resolution images. For a fetus lying obliquely in the uterus, the most common approach is transposition, in which the transducer is placed parallel to the abdomen. This has been shown to be a relatively accurate method for diagnosing congenital CNS disorders, indicated for use in fetuses at high risk of brain defects, such as parents of the same age. blood, a family history of brain defects or genetic diseases, maternal infection of the uterus or use of potentially teratogenic drugs such as psychotropic drugs, exposure to radiation or chemicals after pregnancy pregnancy...
Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with full prenatal check-ups, 3D ultrasound, Periodic 4D and routine tests to ensure that the mother is healthy and the fetus is developing comprehensively. Pregnant women will no longer be alone when entering labor because having a loved one to help them during childbirth always brings peace of mind and happiness.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.

Articles refer to sources: ncbi.nlm.nih.gov, intechopen.com, radiologykey.com