Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands

J. H. Fleurke-Rozema, T. A. Vogel, B. J. Voskamp, E. Pajkrt, P. P. Van Den Berg, J. R. Beekhuis, C. M. Bilardo, O. F. Brouwer, H. E.K. De Walle, R. J.M. Snijders

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective To examine the impact of introduction of the mid-trimester scan on pregnancy outcome in cases of open spina bifida in two regions of The Netherlands. Methods This was a retrospective cohort study of 190 cases of open spina bifida diagnosed pre- or postnatally, with an estimated date of delivery between 2003 and 2011. Results With implementation of the mid-trimester scan the percentage of cases of open spina bifida detected before the 24th week of pregnancy increased from 43% to 88%. The rise in prenatal detection rate was associated with a significant increase in the number of terminated pregnancies and a decrease in the rate of perinatal loss; the percentage of children born alive did not change significantly. In the subgroup that underwent a scan between 18 and 24 weeks of pregnancy, cranial signs were present in 94.4% of cases. Conclusion Introduction of the mid-trimester scan has led to an increase in early identification of pregnancies complicated by open spina bifida. Pregnancies previously destined to end in perinatal loss are now terminated whilst pregnancies with a relatively good prognosis are frequently continued; the number of children with open spina bifida who are born alive has not changed significantly. Our study confirms that prenatal diagnosis is usually triggered by visualization of a lemon-shaped skull or a banana-shaped cerebellum.

Original languageEnglish
Pages (from-to)553-556
Number of pages4
JournalUltrasound in Obstetrics and Gynecology
Volume43
Issue number5
DOIs
Publication statusPublished - 1 Jan 2014

Cite this

Fleurke-Rozema, J. H., Vogel, T. A., Voskamp, B. J., Pajkrt, E., Van Den Berg, P. P., Beekhuis, J. R., ... Snijders, R. J. M. (2014). Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands. Ultrasound in Obstetrics and Gynecology, 43(5), 553-556. https://doi.org/10.1002/uog.12546
Fleurke-Rozema, J. H. ; Vogel, T. A. ; Voskamp, B. J. ; Pajkrt, E. ; Van Den Berg, P. P. ; Beekhuis, J. R. ; Bilardo, C. M. ; Brouwer, O. F. ; De Walle, H. E.K. ; Snijders, R. J.M. / Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands. In: Ultrasound in Obstetrics and Gynecology. 2014 ; Vol. 43, No. 5. pp. 553-556.
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title = "Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands",
abstract = "Objective To examine the impact of introduction of the mid-trimester scan on pregnancy outcome in cases of open spina bifida in two regions of The Netherlands. Methods This was a retrospective cohort study of 190 cases of open spina bifida diagnosed pre- or postnatally, with an estimated date of delivery between 2003 and 2011. Results With implementation of the mid-trimester scan the percentage of cases of open spina bifida detected before the 24th week of pregnancy increased from 43{\%} to 88{\%}. The rise in prenatal detection rate was associated with a significant increase in the number of terminated pregnancies and a decrease in the rate of perinatal loss; the percentage of children born alive did not change significantly. In the subgroup that underwent a scan between 18 and 24 weeks of pregnancy, cranial signs were present in 94.4{\%} of cases. Conclusion Introduction of the mid-trimester scan has led to an increase in early identification of pregnancies complicated by open spina bifida. Pregnancies previously destined to end in perinatal loss are now terminated whilst pregnancies with a relatively good prognosis are frequently continued; the number of children with open spina bifida who are born alive has not changed significantly. Our study confirms that prenatal diagnosis is usually triggered by visualization of a lemon-shaped skull or a banana-shaped cerebellum.",
keywords = "anomaly scan, banana sign, congenital malformation, lemon sign, screening, ventriculomegaly",
author = "Fleurke-Rozema, {J. H.} and Vogel, {T. A.} and Voskamp, {B. J.} and E. Pajkrt and {Van Den Berg}, {P. P.} and Beekhuis, {J. R.} and Bilardo, {C. M.} and Brouwer, {O. F.} and {De Walle}, {H. E.K.} and Snijders, {R. J.M.}",
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Fleurke-Rozema, JH, Vogel, TA, Voskamp, BJ, Pajkrt, E, Van Den Berg, PP, Beekhuis, JR, Bilardo, CM, Brouwer, OF, De Walle, HEK & Snijders, RJM 2014, 'Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands' Ultrasound in Obstetrics and Gynecology, vol. 43, no. 5, pp. 553-556. https://doi.org/10.1002/uog.12546

Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands. / Fleurke-Rozema, J. H.; Vogel, T. A.; Voskamp, B. J.; Pajkrt, E.; Van Den Berg, P. P.; Beekhuis, J. R.; Bilardo, C. M.; Brouwer, O. F.; De Walle, H. E.K.; Snijders, R. J.M.

In: Ultrasound in Obstetrics and Gynecology, Vol. 43, No. 5, 01.01.2014, p. 553-556.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Impact of introduction of mid-trimester scan on pregnancy outcome of open spina bifida in the Netherlands

AU - Fleurke-Rozema, J. H.

AU - Vogel, T. A.

AU - Voskamp, B. J.

AU - Pajkrt, E.

AU - Van Den Berg, P. P.

AU - Beekhuis, J. R.

AU - Bilardo, C. M.

AU - Brouwer, O. F.

AU - De Walle, H. E.K.

AU - Snijders, R. J.M.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective To examine the impact of introduction of the mid-trimester scan on pregnancy outcome in cases of open spina bifida in two regions of The Netherlands. Methods This was a retrospective cohort study of 190 cases of open spina bifida diagnosed pre- or postnatally, with an estimated date of delivery between 2003 and 2011. Results With implementation of the mid-trimester scan the percentage of cases of open spina bifida detected before the 24th week of pregnancy increased from 43% to 88%. The rise in prenatal detection rate was associated with a significant increase in the number of terminated pregnancies and a decrease in the rate of perinatal loss; the percentage of children born alive did not change significantly. In the subgroup that underwent a scan between 18 and 24 weeks of pregnancy, cranial signs were present in 94.4% of cases. Conclusion Introduction of the mid-trimester scan has led to an increase in early identification of pregnancies complicated by open spina bifida. Pregnancies previously destined to end in perinatal loss are now terminated whilst pregnancies with a relatively good prognosis are frequently continued; the number of children with open spina bifida who are born alive has not changed significantly. Our study confirms that prenatal diagnosis is usually triggered by visualization of a lemon-shaped skull or a banana-shaped cerebellum.

AB - Objective To examine the impact of introduction of the mid-trimester scan on pregnancy outcome in cases of open spina bifida in two regions of The Netherlands. Methods This was a retrospective cohort study of 190 cases of open spina bifida diagnosed pre- or postnatally, with an estimated date of delivery between 2003 and 2011. Results With implementation of the mid-trimester scan the percentage of cases of open spina bifida detected before the 24th week of pregnancy increased from 43% to 88%. The rise in prenatal detection rate was associated with a significant increase in the number of terminated pregnancies and a decrease in the rate of perinatal loss; the percentage of children born alive did not change significantly. In the subgroup that underwent a scan between 18 and 24 weeks of pregnancy, cranial signs were present in 94.4% of cases. Conclusion Introduction of the mid-trimester scan has led to an increase in early identification of pregnancies complicated by open spina bifida. Pregnancies previously destined to end in perinatal loss are now terminated whilst pregnancies with a relatively good prognosis are frequently continued; the number of children with open spina bifida who are born alive has not changed significantly. Our study confirms that prenatal diagnosis is usually triggered by visualization of a lemon-shaped skull or a banana-shaped cerebellum.

KW - anomaly scan

KW - banana sign

KW - congenital malformation

KW - lemon sign

KW - screening

KW - ventriculomegaly

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DO - 10.1002/uog.12546

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