An abnormal screening ultrasound: concordance with a tertiary obstetrical ultrasound unit

Prenatal neurosurgical counseling for conditions affecting the fetal nervous system

OBJECTIVE

The aim of this study was to share a single center's experience of prenatal neurosurgical counseling and explore pregnant women's experiences with counseling.

MATERIAL AND METHODS

This retrospective study analyzed data for 81 women who received prenatal counseling in a single institution (same senior pediatric neurosurgeon) over a 6-year period. Additionally, a retrospective questionnaire study was conducted with 33 women who chose to continue their pregnancy, to assess the strengths and weaknesses of counseling and analyze the reasons for their decision.

RESULTS

Spinal dysraphism was the most frequent condition leading to prenatal counseling, followed by conditions affecting the cerebrospinal fluid. 57.6% of the women did not follow the French national recommendations on folic acid supplementation in the periconceptional period, and 38.3% underwent termination of pregnancy (TOP). One-third of the 33 women who answered our questionnaire changed their mind about TOP after counseling, and 50% reported that the information provided influenced their decision.

CONCLUSION

Prenatal neurosurgical counseling is nowadays an important part of a pediatric neurosurgeon's practice. It provides specific information to the woman to decide whether to continue the pregnancy. Urological concerns are frequent among the malformations encountered. Hence, we conclude that these women should be offered the possibility of seeing a urologist. Areas for improvement include greater awareness regarding folic acid supplementation and improved psychological care. The advantage for a woman of consulting a neurosurgeon consists in receiving information that is as accurate as possible about the level of disability of the future child and about surgery and follow-up.

Holoprosencefalia. Papel de la resonancia magnética en el diagnóstico prenatal

We presented a case affected of trisomía 13 and fetal malformations. Prenatal sonography and magnetic resonance imaging were performed. The fetus suffered semilobar holoprosencephaly, craniofacial malformations and tetralogy of Fallot. A review of sonographics and magnetic resonance findings is presented emphasizing the role of magnetic resonance as a complementary imaging technique when sonography has diagnostic limitations.