Natural History of Ventriculomegaly in Fetal Agenesis of the Corpus Callosum

Masmejan, Sophie; Blasér, Susan; Keunen, Johannes; Seaward, Gareth; Windrim, Rory; Kelly, Edmond; Ryan, Greg; Baud, David; Mieghem, Tim Van

doi:10.1002/jum.15124

Cited by 8 publications

(20 citation statements)

References 23 publications

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“…A total of 540 were identified; 109 were assessed with respect to their eligibility for inclusion and 14 studies were included in the systematic review (Tables 1 and S1, Figure 1). 8,24–36 These 14 studies included 798 fetuses, of which 258 were affected by isolated ACC, defined as either complete or partial absence of the CC with no additional anomalies on ultrasound. The definition of isolated ACC was based upon multiplanar neurosonography in seven studies (460 fetuses), and a standard sonographic assessment of fetal brain was undertaken in the remaining seven studies (338 fetuses).…”

Section: Resultsmentioning

confidence: 99%

“…The validity of our study is nevertheless limited by the quality of the original studies, all of which had a retrospective design, a small sample size and were heterogeneous in gestational age at ultrasound and MRI assessment. The interval between ultrasound and MRI was not specified [25][26][27][28][29][30][31][32]35 or varied markedly across studies, ranging from 14 days 8,33,35,36 to more than 4 weeks. 24 Therefore the role of MRI might have been overestimated due to the evolutive nature of some abnormalities (such as heterotopias) rather than the imaging method used for detecting them.…”

Section: Discussionmentioning

confidence: 99%

“…Another possible limitation was the incomplete reporting of characteristics that could potentially influence diagnostic performance of ultrasound. Only seven studies clearly stated that ultrasound assessment included neurosonography, [22][23][24][25][26]29,32 whereas in the remaining studies, no information on ultrasound imaging protocol could be extracted. 8,29,30,32,33,35,36 Nonetheless, we assumed that, since a classification of the anomaly in complete or partial ACC was available, the assessment included at least a mid-sagittal view of the brain.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 540 were identified; 109 were assessed with respect to their eligibility for inclusion and 14 studies were included in the systematic review (Tables 1 and S1, Figure 1). 8,[24][25][26][27][28][29][30][31][32][33][34][35][36] The results of the quality assessment of the included studies are presented in Table 2. Most of the included studies showed a good overall score.…”

Section: General Characteristicsmentioning

confidence: 99%

“…Twelve studies8,[24][25][26][27][28][29][30][31][32][33]35,36 (178 fetuses) explored the role of fetal MRI in detecting associated anomalies in fetuses with a prenatal diagnosis of isolated complete ACC on ultrasound. Overall, MRI detected 10.9% (95% CI 4.1-20.6) of fetal anomalies not detected on ultrasound, whereas the rate of additional anomalies detected only at birth and missed also at prenatal MRI was 4.3% (95% CI 1.4-8.8)…”

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confidence: 99%

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Role of prenatal magnetic resonance imaging in fetuses with isolated agenesis of corpus callosum in the era of fetal neurosonography: A systematic review and meta‐analysis

Sileo

Mascio

Rizzo

et al. 2020

Acta Obstet Gynecol Scand

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Introduction Corpus callosum agenesis (ACC) is frequently diagnosed during fetal life; its prognosis depends also on additional anomalies. The additional value of fetal magnetic resonance imaging (MRI) in fetuses with “isolated” complete (cACC) and partial (pACC) agenesis of the corpus callosum on ultrasound is still debated. Material and methods We performed a systematic literature review and meta‐analysis including fetuses with a prenatal diagnosis of cACC and pACC without associated structural anomalies on ultrasound, undergoing fetal MRI. The primary outcome was the rate of additional anomalies detected at fetal MRI. Further analyses assessed the effect of type of ultrasound assessment (neurosonography vs standard axial assessment), gestational age at fetal MRI and rate of postnatally detected brain anomalies. Random‐effect meta‐analyses of proportions were used to analyze the data. Results Fourteen studies (798 fetuses) were included. In cases with isolated cACC, 10.9% (95% CI 4.1‐20.6) and 4.3% (95% CI 1.4‐8.8) additional anomalies were detected by fetal MRI and postnatally, respectively. Stratifying according to the type of ultrasound assessment, the rate of associated anomalies detected only on fetal MRI was 5.7% (95% CI 0.5‐16.0) with dedicated neurosonography and 18.5% (95% CI 7.8‐32.4) with a standard axial assessment. In fetuses with isolated pACC, 13.4% (95% CI 4.0‐27.0) and 16.2% (95% CI 5.9‐30.3) additional anomalies were detected by fetal MRI or postnatally, respectively. Stratifying according to the type of ultrasound assessment, the rate of associated anomalies detected only on fetal MRI was 11.4% (95% CI 2.7‐25.0) when dedicated neurosonography was performed. Cortical and posterior fossa anomalies represented the most common anomalies missed at ultrasound with both cACC and pACC. Due to the very small number of included cases, stratification according to early (<24 weeks of gestation) and late (>24 weeks) fetal MRI could not be done for either cACC or pACC. Conclusions The rate of associated anomalies detected exclusively at fetal MRI in isolated ACC undergoing neurosonography is lower than previously reported. Cortical and posterior fossa anomalies are among the most common anomalies detected exclusively at MRI, thus confirming the crucial role of fetal MRI in determining the prognosis of these fetuses. However, some anomalies still go undetected prenatally and this should be stressed during parental counseling.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…A total of 540 were identified; 109 were assessed with respect to their eligibility for inclusion and 14 studies were included in the systematic review (Tables 1 and S1, Figure 1). 8,[24][25][26][27][28][29][30][31][32][33][34][35][36] The results of the quality assessment of the included studies are presented in Table 2. Most of the included studies showed a good overall score.…”

Section: General Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

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Role of prenatal magnetic resonance imaging in fetuses with isolated agenesis of corpus callosum in the era of fetal neurosonography: A systematic review and meta‐analysis

Sileo

Mascio

Rizzo

et al. 2020

Acta Obstet Gynecol Scand

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The challenges for patients and sonographers when complex obstetric anomalies are identified

Shakes

Deslandes

2021

Sonography

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The prenatal identification of complex obstetric anomalies can present issues for expectant parents, sonographers and departments of obstetric ultrasound. The limitations of imaging technologies, ongoing fetal development and various interpretations of anomalies and prognosis create ambiguity. Complexity is further heightened by a lack of policies and training related to the communication of unexpected findings and support for sonographers who work with expectant parents during or after times of significant distress and trauma. This case report details challenges presented upon a third-trimester diagnosis of a complex obstetric anomaly agenesis of the corpus callosum and offers recommendations to reduce the negative psychosocial consequences of complex obstetric anomaly diagnosis.

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Correlation of fetal ventricular size and need for postnatal cerebrospinal fluid diversion surgery in open spina bifida

Agrawal

AlRefai

Abbasi

et al. 2022

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?This study on fetuses with open spina bifida supports the previous finding of an association between the timing of closure (prenatal or postnatal) and the need for postnatal cerebrospinal fluid (CSF) diversion. Our findings also demonstrate that ventriculomegaly is associated independently with the need for postnatal CSF diversion, irrespective of timing of closure. Fetal ventriculomegaly progresses at a similar rate in fetuses with open spina bifida that undergo prenatal closure and those that undergo postnatal closure. What are the clinical implications of this work?The findings of this study should help in clinical counseling regarding the need for postnatal CSF diversion in patients undergoing fetal or postnatal spina bifida closure.

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Natural History of Ventriculomegaly in Fetal Agenesis of the Corpus Callosum

Cited by 8 publications

References 23 publications

Role of prenatal magnetic resonance imaging in fetuses with isolated agenesis of corpus callosum in the era of fetal neurosonography: A systematic review and meta‐analysis

Role of prenatal magnetic resonance imaging in fetuses with isolated agenesis of corpus callosum in the era of fetal neurosonography: A systematic review and meta‐analysis

The challenges for patients and sonographers when complex obstetric anomalies are identified

Correlation of fetal ventricular size and need for postnatal cerebrospinal fluid diversion surgery in open spina bifida

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