Prenatal Sacral Anomalies Leading to the Detection of Associated Spinal Cord Malformations
Morel, Baptiste; Friszer, Stéphanie; Jouannic, Jean-Marie; Pointe, Hubert Ducou Le; Blondiaux, Eléonore; Garel, Catherine
In: Fetal Diagn Ther, vol. 42, no. 4, pp. 294–301, 2017, ISSN: 1421-9964.
@article{pmid28463829,
title = {Prenatal Sacral Anomalies Leading to the Detection of Associated Spinal Cord Malformations},
author = {Baptiste Morel and Stéphanie Friszer and Jean-Marie Jouannic and Hubert Ducou Le Pointe and Eléonore Blondiaux and Catherine Garel},
doi = {10.1159/000457795},
issn = {1421-9964},
year = {2017},
date = {2017-01-01},
journal = {Fetal Diagn Ther},
volume = {42},
number = {4},
pages = {294--301},
abstract = {INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly.nnMATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies. We included all cases of sacral anomalies with available postnatal or postmortem outcomes (imaging and/or pathologic data) and excluded all cases of open dysraphism (myelomeningocele).nnRESULTS: Nineteen patients were included. The mean gestational age was 28 weeks (21-39). Sacral anomalies included 2 cases of complete agenesis, 12 cases of partial agenesis, 4 segmentation anomalies, and 1 case of abnormal angulation of the sacral spine. Fourteen associated spinal cord malformations included 8 tethered spinal cords, 5 truncated spinal cords, and 1 lipoma of the filum terminale. All anomalies were confirmed by postnatal or postmortem examinations.nnCONCLUSIONS: Sacral anomalies detected during basic sonographic examination represent an important warning sign for associated spinal cord anomalies, with possible poor neonatal outcome.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly.nnMATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies. We included all cases of sacral anomalies with available postnatal or postmortem outcomes (imaging and/or pathologic data) and excluded all cases of open dysraphism (myelomeningocele).nnRESULTS: Nineteen patients were included. The mean gestational age was 28 weeks (21-39). Sacral anomalies included 2 cases of complete agenesis, 12 cases of partial agenesis, 4 segmentation anomalies, and 1 case of abnormal angulation of the sacral spine. Fourteen associated spinal cord malformations included 8 tethered spinal cords, 5 truncated spinal cords, and 1 lipoma of the filum terminale. All anomalies were confirmed by postnatal or postmortem examinations.nnCONCLUSIONS: Sacral anomalies detected during basic sonographic examination represent an important warning sign for associated spinal cord anomalies, with possible poor neonatal outcome.
[Ultrasound screening for birth defects: A medico-economic review]
Ferrier, C; Dhombres, F; Guilbaud, L; Durand-Zaleski, I; Jouannic, J-M
In: Gynecol Obstet Fertil Senol, vol. 45, no. 7-8, pp. 408–415, 2017, ISSN: 2468-7189.
@article{pmid28720225,
title = {[Ultrasound screening for birth defects: A medico-economic review]},
author = {C Ferrier and F Dhombres and L Guilbaud and I Durand-Zaleski and J-M Jouannic},
doi = {10.1016/j.gofs.2017.06.007},
issn = {2468-7189},
year = {2017},
date = {2017-01-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {45},
number = {7-8},
pages = {408--415},
abstract = {OBJECTIVES: The systematic use of ultrasound during pregnancy aims at birth defect detection. Our objective was to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.nnMETHODS: We carried out a literature review on Medline via PubMed between 1985 and 2015, from the economic perspective of the prenatal ultrasound screening for fetal malformations.nnRESULTS: The literature on this subject was sparse and we selected only twelve articles presenting relevant economic data, of which only eight were proper medico-economic studies. We found arguments for the economic effectiveness of ultrasound screening for fetal malformation detection, which is largely linked to the terminations of pregnancies and to the cost of the handicaps "avoided". However, none of the reviewed articles could reach medico-economic conclusions. Additionally, we highlighted various elements making economic analyses more complex in this field: the choice of the method, the uncertainty around two essential parameters (the efficiency of ultrasound and the costs of procedures) and the difficulties to compare or to generalize results. We also noticed important methodological heterogeneity among the studies and the absence of French study.nnCONCLUSIONS: Previously published data are insufficient to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: The systematic use of ultrasound during pregnancy aims at birth defect detection. Our objective was to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.nnMETHODS: We carried out a literature review on Medline via PubMed between 1985 and 2015, from the economic perspective of the prenatal ultrasound screening for fetal malformations.nnRESULTS: The literature on this subject was sparse and we selected only twelve articles presenting relevant economic data, of which only eight were proper medico-economic studies. We found arguments for the economic effectiveness of ultrasound screening for fetal malformation detection, which is largely linked to the terminations of pregnancies and to the cost of the handicaps “avoided”. However, none of the reviewed articles could reach medico-economic conclusions. Additionally, we highlighted various elements making economic analyses more complex in this field: the choice of the method, the uncertainty around two essential parameters (the efficiency of ultrasound and the costs of procedures) and the difficulties to compare or to generalize results. We also noticed important methodological heterogeneity among the studies and the absence of French study.nnCONCLUSIONS: Previously published data are insufficient to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.
Limited Dorsal Myeloschisis: A Diagnostic Pitfall in the Prenatal Ultrasound of Fetal Dysraphism
Friszer, Stéphanie; Dhombres, Ferdinand; Morel, Baptiste; Zerah, Michel; Jouannic, Jean-Marie; Garel, Catherine
In: Fetal Diagn Ther, vol. 41, no. 2, pp. 136–144, 2017, ISSN: 1421-9964.
@article{pmid27160821,
title = {Limited Dorsal Myeloschisis: A Diagnostic Pitfall in the Prenatal Ultrasound of Fetal Dysraphism},
author = {Stéphanie Friszer and Ferdinand Dhombres and Baptiste Morel and Michel Zerah and Jean-Marie Jouannic and Catherine Garel},
doi = {10.1159/000445995},
issn = {1421-9964},
year = {2017},
date = {2017-01-01},
journal = {Fetal Diagn Ther},
volume = {41},
number = {2},
pages = {136--144},
abstract = {OBJECTIVE: To determine the ultrasonographic characteristics of limited dorsal myeloschisis (LDM) at prenatal ultrasound (US) and to highlight the main features that may help differentiate LDM and myelomeningocele (MMC).nnMETHODS: In a tertiary reference center in fetal medicine, we prospectively collected the medical data and ultrasonographic characteristics of all patients referred for in utero prenatal repair of MMC between November 1, 2013 and April 30, 2015.nnRESULTS: Among the 29 patients assessed, the diagnosis of MMC was revised in 7 cases. In 6 cases, the diagnosis of LDM was established. On US scan, LDM was characterized by a spinal saccular lesion with a thick peripheral lining in continuity with the adjacent skin. Within the saccular lesion, a thick hyperechoic well-delineated structure was present in continuity with the spinal cord. Cerebral structures were normal except for 2 cases showing a cisterna magna slightly decreased in size. In the remaining 22 cases MMC was confirmed, with cerebral anomalies present in 21/22 cases (95.5%).nnCONCLUSION: LDM is a form of closed dysraphism accessible to prenatal diagnosis by US that may mimic MMC. Considering the major difference in prognosis between these two entities, physicians should be aware of the existence and ultrasonographic characteristics of LDM.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To determine the ultrasonographic characteristics of limited dorsal myeloschisis (LDM) at prenatal ultrasound (US) and to highlight the main features that may help differentiate LDM and myelomeningocele (MMC).nnMETHODS: In a tertiary reference center in fetal medicine, we prospectively collected the medical data and ultrasonographic characteristics of all patients referred for in utero prenatal repair of MMC between November 1, 2013 and April 30, 2015.nnRESULTS: Among the 29 patients assessed, the diagnosis of MMC was revised in 7 cases. In 6 cases, the diagnosis of LDM was established. On US scan, LDM was characterized by a spinal saccular lesion with a thick peripheral lining in continuity with the adjacent skin. Within the saccular lesion, a thick hyperechoic well-delineated structure was present in continuity with the spinal cord. Cerebral structures were normal except for 2 cases showing a cisterna magna slightly decreased in size. In the remaining 22 cases MMC was confirmed, with cerebral anomalies present in 21/22 cases (95.5%).nnCONCLUSION: LDM is a form of closed dysraphism accessible to prenatal diagnosis by US that may mimic MMC. Considering the major difference in prognosis between these two entities, physicians should be aware of the existence and ultrasonographic characteristics of LDM.
[No title]
0000.
@proceedings{pmid38024482,
title = {[No title]},
keywords = {},
pubstate = {published},
tppubtype = {proceedings}
}