Prenatal ultrasound evaluation of segmental level of neurological lesion in fetuses with myelomeningocele: development of a new technique

• DOI: 10.1002/uog.15732
• Publication Date: 2015-08-26T09:55:05Z
• Authors: E. Carreras; A. Maroto; T. Illescas; M. Meléndez; S. Arévalo; J. L. Peiró; C. G. García‐Font...; M. Belfort; A. Cuxart
• Keywords: Neurological examination; Fetal Surgery; Fetal movement

To report our preliminary experience in the use of prenatal ultrasound examination to assess lower-limb movements fetuses with myelomeningocele. We aimed determine accuracy this method establish segmental level neurological lesion, as is best known predictor future ability walk.This was a preliminary, observational study including myelomeningocele operated on prenatally. The patterns present and absent affected fetuses' lower limbs were evaluated systematically by examination. According nerve function associated each muscle group, lesion established before birth. agreement for levels assigned, between technique classical clinical after birth (gold standard), tested using weighed kappa (wκ) index.Seventy-one at Hospital Universitari Vall d'Hebron. After counseling, parents opted surgery (26 cases), termination pregnancy (43 cases) or postnatal repair (two cases). Five patients did not fulfil inclusion criteria three excluded In 18 that underwent analyzed, assigned 91.7% right limb (wκ = 0.80) 88.9% left 0.73).The found assignment suggests sonographic evaluation feasible This may provide accurate individualized information about motor ambulation prognosis