F108Correlation between prenatal ultrasound findings and postnatal outcome in 37 cases of isolated spina bifida aperta

Abstract

BackgroundThe aim of this study was to find prenatal prognosis predictors in spina bifida aperta.MethodThirty‐seven cases of isolated Spina Bifida Aperta were prospectively evaluated from 1995 to 2000. Prenatal ultrasound findings such as hydrocephaly, talipes, site of the lesion and prenatal evolution were correlated with postnatal neurological outcome. Minimum postnatal follow up was one year.ResultsMortality rate was 24% (9/37). Among 28 survivors, 21 (71%) had normal intellectual development. Six (6/28–21%) had normal intellectual and motor development Fourteen (14/28–50%) had normal intellectual development but severe motor impairment. Severe motor and intellectual impairment were present in 8/28 survivors (29%). All of them had hydrocephaly (mean ventriculo‐hemisphere ratio = 0.75), and 5(5/8–63%) had talipes. Site of spina was higher in this group with no case of sacral meningomielocele. All 28 patients had problems in controlling sphincters which was analysed separately from inferior limbs motor development.ConclusionsThe group with small sacral lesions without hydrocephaly nor talipes had good prognosis, with normal intellectual and inferior limb motor development but no sphincter control. In any other situation a poor prognosis was observed with a high mortality rate. Longer follow up is needed to better ascertain and confirm these prognostic factors.