Comănescu M C, Căpitănescu R G, Comănescu A C, Cernea N, Popa A, Barbu E M, Albulescu D M
PhD Researcher, University of Medicine and Pharmacy of Craiova, Romania.
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania.
Curr Health Sci J. 2019 Apr-Jun;45(2):167-173. doi: 10.12865/CHSJ.45.02.06. Epub 2019 Jun 30.
Central nervous system (CNS) malformations represent 1% of all births. For this reason, efforts are being made to increase detection of such anomalies prenatally. Consequently, a detailed assessment of the fetal nervous system in the first trimester of pregnancy is no longer a utopia as this kind of evaluation can detect severe malformation such as acrania, neural tube defects, holoprosencephaly or can draw attention regarding to anomalies currently detected in the second trimester due to certain markers of diagnosis.
The study included 1376 pregnant women with gestational ages between 11 and 14 weeks, who were referred to our unit for sonographic evaluation. We analyzed in all patients the fetal brain in axial and mid-sagittal views, assessing markers like intracranial translucency, brainstem/brainstem-occipital bone (BS/BSOB) ratio, choroid plexus (CP/HA) ratio, the octopus sign in order to detect as many anomalies in the first trimester of pregnancy.
We detected 6 CNS anomalies during our search. All markers assessed were abnormal in all pathological cases.
A detailed assessment of the fetal brain is recommended at 11-14 weeks because the earlier the diagnosis is confirmed, the lower the chances of obstetrical, psychological complications to supervene.
中枢神经系统（CNS）畸形占所有出生病例的1%。因此，人们正在努力增加产前对此类异常的检测。因此，在妊娠早期对胎儿神经系统进行详细评估不再是空想，因为这种评估可以检测到严重畸形，如无脑儿、神经管缺陷、前脑无裂畸形，或者由于某些诊断标志物而引起对目前在妊娠中期检测到的异常的关注。
该研究纳入了1376名孕周在11至14周之间的孕妇，她们被转诊至我们科室进行超声评估。我们对所有患者的胎儿大脑进行了轴位和正中矢状位观察，评估了如颅内透明层、脑干/脑干枕骨（BS/BSOB）比值、脉络丛（CP/HA）比值、章鱼征等标志物，以便在妊娠早期检测出尽可能多的异常。
我们在研究过程中检测到6例中枢神经系统异常。在所有病理病例中，所评估的所有标志物均异常。
建议在11 - 14周对胎儿大脑进行详细评估，因为诊断越早确定，发生产科、心理并发症的几率就越低。
