Prediction of microcephaly at birth using three reference ranges for fetal head circumference: can we improve prenatal diagnosis?

Leibovitz, Z.; Daniel-Spiegel, Etty; Malinger, G.; Haratz, K.K.; Tamarkin, Mordechai; Gindes, L.; Schreiber, Letizia; Ben-Sira, Liat; Lev, Dorit; Shapiro, I.; Bakry, H.; Weizman, B.; Zreik, A.; Egenburg, S.; Arad, Ayala; Tepper, R.; Kidron, Debora; Lerman‐Sagie, Tally

doi:10.1002/uog.15801

Cited by 60 publications

(76 citation statements)

References 24 publications

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“…However, after the birth, the newborns with morphological alterations will need to be taken to a reference service for neonatal microcephaly/ZIKV for evaluation and monitoring. 6 The lowest mean of length and weight at birth can be justified by a possible restriction of intrauterine growth in agreement with other studies that describe congenital infection by ZIKV. 25,26 However, most of these newborn infants were classified as appropriate for gestational age.…”

Section: Discussionsupporting

confidence: 77%

“…[1][2][3][4][5] The virus is transmitted by mosquitoes, particularly the Aedes species, 4 by direct transmission among humans, perhaps sexual intercourse, and as perinatal, all have been described. 1,6 Serious consequences of arboviruses transmission to maternal-fetal have been reported, in particularly for Chikungunya (as being associated to hemorrhagic fever and encephalopathy) and dengue (leading to premature delivery, fetal death, low birth weight, fetal abnormalities, prematurity and acute fetal distress). 7,8 However, until this moment there are no reports in the medical literature associating Zika virus with congenital anomalies, particularly, microcephaly.…”

Section: Introductionmentioning

confidence: 99%

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Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

Souza

Faquin

et al. 2016

Rev. Bras. Saude Mater. Infant.

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Objectives: to describe altered intrauterine ultrasound, analyze fetal head circumference (HC) growth and neonates' outcomes among presumed cases of congenital Zika syndrome in Brazil. Methods: 30 women were included in the study with suspected history of Zika virus (ZIKV) infection during pregnancy and fetal's brain altered on ultrasound diagnosis. Sociodemographic and obstetric characteristics, prenatal altered ultrasounds, HC and other perinatal outcomes have been described. The relation between HC and gestational age was analyzed by using random regression effects based on polynomials fractions. The Z test was calculated to determine an instant variant mean rate of the HC for each gestational age. Results: the mean gestational age of the ultrasound diagnosis was 33.3 + 4.7 weeks and HC at birth was 28.9 + 1.6 cm. The main altered brain ultrasound was microcephaly (96.7%). The analysis of the fetal head circumference showed an estimated increase of the average HC, as to gestational age, it did not occur in a linear form. The instant HC variation rate increased according to gestational age (p<0,001). Conclusions: Fetal's main morphological alteration was microcephaly, observing an increase in the head circumference according to gestational age in a non-linear form and the variation decreased with gestational age.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

Souza

Faquin

et al. 2016

Rev. Bras. Saude Mater. Infant.

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“…Third, OFC measurements may not be reliable during the first days of life due to the presence of delivery sequelae, such as caput succedanum or cephalohematoma; therefore, the OFC measurement should be confirmed 24 h after birth and diagnosis only made thereafter (25). Finally, in utero predictions for microcephaly at birth using the head circumference (HC) measurement may not be accurate; an abnormal HC in utero should be interpreted in its clinical context (26,27).…”

Section: Definition and Diagnosismentioning

confidence: 99%

“…The course of fetal ZIKV infection, however, is not currently known, and specific lesions may develop late in pregnancy. In addition, the correlation between head circumference in utero and OFC at birth is stronger when measurements are performed during the third trimester (i.e., after 28 weeks gestation) (27,262). It should be emphasized that while prenatal ultrasound may suggest microcephaly, the definitive diagnosis can only be made at birth.…”

Section: Clinical Management Prenatal Carementioning

confidence: 99%

“…It should be emphasized that while prenatal ultrasound may suggest microcephaly, the definitive diagnosis can only be made at birth. The presence of additional cerebral anomalies may increase the predictive value in utero (27). Baud et al (260) and several agencies (256)(257)(258)263) have suggested that at least one additional ultrasound should be performed in the third trimester in pregnant women exposed to ZIKV, independent of maternal serological status, even in the absence of fetal anomalies on previous ultrasounds.…”

Section: Clinical Management Prenatal Carementioning

confidence: 99%

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Emerging Role of Zika Virus in Adverse Fetal and Neonatal Outcomes

et al. 2016

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SUMMARYThe rapid spread of the Zika virus (ZIKV) in the Americas and its potential association with thousands of suspected cases of microcephaly in Brazil and higher rates of Guillain-Barré syndrome meet the conditions for a Public Health Emergency of International Concern, as stated by the World Health Organization in February 2016. Two months later, the Centers for Disease Control and Prevention (CDC) announced that the current available evidence supports the existence of a causal relationship between prenatal Zika virus infection and microcephaly and other serious brain anomalies. Microcephaly can be caused by several factors, and its clinical course and prognosis are difficult to predict. Other pathogens with proven teratogenicity have been identified long before the current ZIKV epidemic. Despite the growing number of cases with maternal signs of infection and/or presence of ZIKV in tissues of affected newborns or fetuses, it is currently difficult to assess the magnitude of increase of microcephaly prevalence in Brazil, as well as the role of other factors in the development of congenital neurological conditions. Meanwhile, health agencies and medical organizations have issued cautious guidelines advising health care practitioners and expectant couples traveling to, returning from, or living in affected areas. Analogous to dengue virus (DENV) epidemics, ZIKV has the potential to become endemic in all countries infested byAedesmosquitoes, while new mutations could impact viral replication in humans, leading to increased virulence and consequently heightened chances of viral transmission to additional naive mosquito vectors. Studies are urgently needed to answer the questions surrounding ZIKV and its role in congenital neurological conditions.

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Voxel‐based morphometric magnetic resonance imaging evaluation of small head fetus: A comparative study with normal developmental fetus

Chen

Zhang

Pan

et al. 2023

Intl J of Devlp Neuroscience

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Purpose To explore the application value of voxel‐based morphometric (VBM) in prenatal diagnosis of microcephaly. Methods A retrospective study of magnetic resonance imaging of fetuses with microcephaly was performed using a single‐shot fast spin echo sequence; semiautomatic segmentation of grey matter (GM), white matter (WM), and cerebrospinal fluid (CSF); calculation of their volumes; and VBM analysis of their GM. Two independent samples t‐test was used to statistically analyse the fetal GM volume in the microcephaly and normal control groups. Total intracranial volume (TIV), GM volume, WM volume, and CSF volume were linearly regressed against gestational age and compared between the two groups. Results In the fetus with microcephaly, GM volume of frontal lobe, temporal lobe, cuneus, anterior central gyrus, and posterior central gyrus decreased significantly (P < 0.001, corrected by family‐wise error at mass level). The GM volume of microcephaly was significantly lower than that of the control group (except for 28 weeks of gestation) (P < 0.05). TIV, GM volume, WM volume, and CSF volume were all positively correlated with gestational age, and the curves in the microcephaly group were all lower than those in the control group. Conclusion Compared with the normal control group, the GM volume of microcephaly fetuses decreased, and there were significant differences in many brain regions through VBM analysis.

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Prediction of microcephaly at birth using three reference ranges for fetal head circumference: can we improve prenatal diagnosis?

Abstract: Objective To evaluate the prediction of microcephaly at birth (micB) using established and two new reference ranges for fetal head circumference (HC) and to assess whether integrating additional parameters can improve prediction. Methods

Cited by 60 publications

References 24 publications

Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

Emerging Role of Zika Virus in Adverse Fetal and Neonatal Outcomes

Voxel‐based morphometric magnetic resonance imaging evaluation of small head fetus: A comparative study with normal developmental fetus

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