Matuszewski L, Perdriolle-Galet E, Clerc-Urmès I, Bach-Segura P, Klein O, Masutti J P, Morel O
Service d'obstétrique et médecine fœtale, maternité régionale universitaire, rue du Dr-Heydenreich, 54000 Nancy, France.
Service d'obstétrique et médecine fœtale, maternité régionale universitaire, rue du Dr-Heydenreich, 54000 Nancy, France; Laboratoire imagerie adaptative diagnostique et interventionnelle (IADI), unité Inserm U947, université de Lorraine, 54500 Vandœuvre-lès-Nancy, France.
J Gynecol Obstet Hum Reprod. 2017 Mar;46(3):291-296. doi: 10.1016/j.jogoh.2016.10.009. Epub 2017 Feb 7.
Neural tube defects (NTD) are congenital anomalies that can cause significant neurological long-term disabilities. Theses malformations are accessible to prenatal diagnosis and quite recently, to in utero repair for some myelomeningoceles. The aim of this study was to analyse the correlation between prenatal and postnatal examinations.
A descriptive retrospective monocentric study has been conducted between January 2004 and December 2014 in a tertiary care maternity. All patients who benefited a prenatal diagnosis of NTD for their foetus, and for whom postnatal data were available were included. Prenatal and postnatal data, especially type of dysraphism, levels of defect and extent, and associated anomalies were compared.
Sixty spinal dysraphisms were diagnosed antenataly. Concerning the type of dysraphism, ultrasound diagnosis was well correlated with postnatal findings (ρ=0.7048). Prenatal level and extent were correlated with postnatal data (respectively ρ=0.539 and ρ=0.562). Vertebral upper level defined by ultrasound agreed with postnatal constatations in 80.8% of cases within one vertebra, and in 84.6% of cases within two vertebras. Concerning indirect signs of spina bifida, prenatal data agreed with postnatal ones for most of them, especially for Arnold Chiari II malformation.
There is a high correlation between prenatal and postnatal data. Prenatal ultrasound seems to be efficient for description of neural tube defects and to identify foetuses for which the benefit of in utero surgery exists.
神经管缺陷（NTD）是先天性异常，可导致严重的长期神经功能残疾。这些畸形可进行产前诊断，最近，对于一些脊髓脊膜膨出还可进行宫内修复。本研究的目的是分析产前检查与产后检查之间的相关性。
2004年1月至2014年12月在一家三级护理产科进行了一项描述性回顾性单中心研究。纳入所有其胎儿接受了神经管缺陷产前诊断且有产后数据的患者。比较产前和产后数据，尤其是脊柱裂类型、缺陷水平和范围以及相关异常情况。
产前诊断出60例脊柱裂。关于脊柱裂类型，超声诊断与产后结果相关性良好（ρ=0.7048）。产前水平和范围与产后数据相关（分别为ρ=0.539和ρ=0.562）。超声确定的椎体上界与产后检查结果在80.8%的病例中相差一个椎体范围内一致，在84.6%的病例中相差两个椎体范围内一致。关于脊柱裂的间接征象，大多数产前数据与产后数据一致，尤其是对于Arnold Chiari II畸形。
产前和产后数据之间存在高度相关性。产前超声似乎能有效地描述神经管缺陷并识别适合进行宫内手术的胎儿。
