We present a case of prenatal diagnosis of congenital rubella. After birth, in addition to traditional serologic and clinical examinations to confirm the infection, we could identify the virus in the "first fluid aspirated from the oropharynx of the newborn", using polimerase chain reaction (PCR). We propose that this first oropharynx fluid (collected routinely immediately after birth) could be used as a source for identification of various congenital infection agents, which may not always be easily identified by current methods.

Objectives: To determine if MR and ultrasound (US) imaging of fetal ventricular system and hindbrain herniation (HBH) can predict motor outcome at birth in prenatally repaired neural tube defect (NTD) cases. Methods: Retrospective cohort study of 47 prenatally NTD repaired cases (17 fetoscopic, 30 open-hysterotomy). At the time of referral, anatomical level of lesion (LL) was determined based on the upper bony spinal defect detected by US. Head circumference and ventricular atrial widths (VAW) were measured on US at referral and before delivery. At the time of referral and six weeks postoperatively, the degree of HBH, VAW and ventricular volume (VV) were evaluated by MRI. Changes in VV and HBH were calculated between both MRIs. Motor level was determined by a pediatric neurosurgeon during the first 48 hours after birth and was compared to the anatomical LL. Poor MF was defined as same motor level as anatomical LL or worse. Logistic regression analyses were performed to define the predictive value of each parameter obtained from brain imaging to identify the risk of having a poor MF. Results: 26% of the cases showed a poor MF at birth. Having a HBH above cervical 1 (C1) vertebrae at the time of referral was less likely to be associated with a poor MF at birth (OR = 0.1, CI95[0.02-0.5]; p < 0.01). None of the other tested MRI or US parameters showed a significant predictive value to identify those cases with poor MF at birth. The anatomical LL was not a strong predictor to identify cases who had poor MF at birth. The detection of fetal ventriculomegaly (>10 or >15mm) before or after the prenatal repair or improvement of HBH after the prenatal repair provided suboptimal predictive values. Conclusions: HBH above C1 before surgery was less likely to be associated with a poor MF at birth. Fetal ventriculomegaly assessed by MRI or US at different time points during pregnancy or the degree of HBH after surgery did not accurately identify prenatally repaired fetuses that had poor MF at birth.

Objectives: To determine if MR and ultrasound (US) imaging of fetal ventricular system and hindbrain herniation (HBH) can predict motor outcome at birth in prenatally repaired neural tube defect (NTD) cases. Methods: Retrospective cohort study of 47 prenatally NTD repaired cases (17 fetoscopic, 30 open-hysterotomy). At the time of referral, anatomical level of lesion (LL) was determined based on the upper bony spinal defect detected by US. Head circumference and ventricular atrial widths (VAW) were measured on US at referral and before delivery. At the time of referral and six weeks postoperatively, the degree of HBH, VAW and ventricular volume (VV) were evaluated by MRI. Changes in VV and HBH were calculated between both MRIs. Motor level was determined by a pediatric neurosurgeon during the first 48 hours after birth and was compared to the anatomical LL. Poor MF was defined as same motor level as anatomical LL or worse. Logistic regression analyses were performed to define the predictive value of each parameter obtained from brain imaging to identify the risk of having a poor MF. Results: 26% of the cases showed a poor MF at birth. Having a HBH above cervical 1 (C1) vertebrae at the time of referral was less likely to be associated with a poor MF at birth (OR = 0.1, CI95[0.02-0.5]; p < 0.01). None of the other tested MRI or US parameters showed a significant predictive value to identify those cases with poor MF at birth. The anatomical LL was not a strong predictor to identify cases who had poor MF at birth. The detection of fetal ventriculomegaly (>10 or >15mm) before or after the prenatal repair or improvement of HBH after the prenatal repair provided suboptimal predictive values. Conclusions: HBH above C1 before surgery was less likely to be associated with a poor MF at birth. Fetal ventriculomegaly assessed by MRI or US at different time points during pregnancy or the degree of HBH after surgery did not accurately identify prenatally repaired fetuses that had poor MF at birth.