Three dimensional/four-dimensional ultrasonography in detection of CNS and non-CNS anomalies in pregnant females with polyhydramnios

Document Type : Original Article

Authors

1 Radiology Department, Faculty of Medicine, Beni-Suef University, Egypt.

2 Radiology Department, Faculty of Medicine, Beni-Suef University, Egypt

3 Obstetrics and Gynecology Department, Faculty of Medicine, Beni-Suef University, Egypt.

Abstract

Background: Great concerns have been obtained for CNS anomalies due to their maternal and fetal morbidities and mortality outcomes. The high prevalence of CNS anomalies has been linked to polyhydramnios in several studies. This study was conducted to evaluate the role of 3D/4D US in the detection of CNS anomalies as compared to other non-CNS anomalies in pregnancy complicated with polyhydramnios.
Methods: This was a cohort study conducted at the radiology department of the University Hospital. The study was done on 110 pregnant females diagnosed with polyhydramnios. Regular visits and follow-ups of patients were scheduled till either delivery or termination of pregnancy.
Results: The most common fetal anomalies were CNS anomalies detected in 20 patients (18.18%) followed by musculoskeletal anomalies in 6 patients (5.5%) then cardiovascular anomalies in 5 patients (4.5%). Chiari malformation represented the most common malformation affecting about 6 fetuses (5.5%) of all the participants. There was a significant agreement between antenatal diagnosis of congenital anomalies as detected by 3D/4D US and postnatal confirmation of the diagnosis.
Conclusions: The gold standard technique in the detection of fetal anomalies is 3D/4D ultrasonography with high accuracy, especially in the detection of CNS malformations. Also, the incidence of CNS malformation in pregnant females complicated with polyhydramnios is more than in other non-CNS anomalies.

Keywords

Main Subjects


  1. Vanda, R., Bazrafkan, M., Rouhani, M., & Bazarganipour, F. (2022). Comparing pregnancy, childbirth, and neonatal outcomes in women with idiopathic polyhydramnios: a prospective cohort study. BMC Pregnancy and Childbirth22(1), 1-7.
  2. Bas Lando, M., Urman, M., Weiss, Y., Srebnik, N., Grisaru-Granovsky, S., Farkash, R., & Sela, H. Y. (2023). Term Idiopathic Polyhydramnios, and Labor Complications. Journal of Clinical Medicine12(3), 981.
  3. Amitai, A., Wainstock, T., Sheiner, E., Walfisch, A., Landau, D., & Pariente, G. (2019). The association between pregnancies complicated with isolated polyhydramnios or oligohydramnios and offspring long-term gastrointestinal morbidity. Archives of gynecology and obstetrics300, 1607-1612.
  4. Kubo, S., Horinouchi, T., Kinoshita, M., Yoshizato, T., Kozuma, Y., Shinagawa, T., & Ushijima, K. (2019). Visual diagnosis in utero: Prenatal diagnosis of Treacher-Collins syndrome using a 3D/4D ultrasonography. Taiwanese Journal of Obstetrics and Gynecology58(4), 566-569.
  5. Yousef, A., Galal, O., & Atta, T. (2020). 4D Sonography in Prenatal Diagnosis of Fetal Anomalies in First &Second Trimester of Pregnancy. Benha Medical Journal37(special issue (Radiology)), 87-99.
  6. Abozaid, K. A., Aborashed, A. A., & Mohamad, M. T. (2022). ROLE OF 3D AND 4D DIMENSIONAL ULTRASONOGRAPHY IN DETECTION OF FETAL BRAIN ANOMALIES IN SECOND TRIMESTER OF PREGNANCY. Al-Azhar International Medical Journal3(11), 141-147.
  7. Hassan, H. H., Mohamed, M. A., & Elgibaly, F. A. Z. R. (2022). Proportion of Central Nervous System Fetal Malformations in patients attending Fetomaternal Unit Minia University as an observation study. Minia Journal of Medical Research33(2), 137-145.
  8. Yu, X., Liu, F., Gao, W., Shi, X., Lu, R., & Pan, L. (2022). Diagnostic Value and High-Risk Factors of Two-Dimensional Ultrasonography Combined with Four-Dimensional Ultrasonography in Prenatal Ultrasound Screening of Fetal Congenital Malformations. Computational and Mathematical Methods in Medicine2022.
  9. Duc, N. M., Nhung, N. T. H., My, T. T. T., Luu, D. T., & Van Lenh, B. (2021). Detecting fetal central nervous system anomalies using magnetic resonance imaging and ultrasound. Medical Archives75(1), 45.
  10. Barišić, L. S., Stanojević, M., Kurjak, A., Porović, S., & Gaber, G. (2017). Diagnosis of fetal syndromes by three-and four-dimensional ultrasound: is there any improvement?. Journal of Perinatal Medicine45(6), 651-665.
  11. Adel, N. M., El Hakeem, A. K. E., AbdelKader, M. A., & Amin, M. A. (2023). What Does 3/4D Ultrasound Add to 2D Examination in The Assessment of Fetal Neural Anomalies: Tertiary Center Experience. The Egyptian Journal of Hospital Medicine90(1), 706-715.
  12. Lalchan, S., Sharma, P., & Gurung, S. D. (2018). Prevalence of Congenital Anomalies in Polyhydramnios: A hospital based study from Western Nepal. Nepalese Journal of Radiology8(1), 25-29.
  13. Kornacki, J., Adamczyk, M., Wirstlein, P., Osiński, M., & Wender-Ożegowska, E. (2017). Polyhydramnios—frequency of congenital anomalies in relation to the value of the amniotic fluid index. Ginekologia polska88(8), 442-445.
  14. Tashfeen, K., & Hamdi, I. M. (2013). Polyhydramnios as a predictor of adverse pregnancy outcomes. Sultan Qaboos University medical journal13(1), 57.
  15. Sundaram, U. A., Dharmalingam, U., & Santhakumar, S. T. (2017). Cross-sectional study of need of targeted USG and its benefits in decreasing foetal and maternal morbidity and mortality by obstetric decision making in a low resource setting. Journal of Evolution of Medical and Dental Sciences6(57), 4236-4242.
  16. Alia, N., & Ahmed, I. (2010). Congenital anomalies: prevalence of congenital abnormalities in 2nd trimester of pregnancy in madina teaching hospital, Faisalabad on gray scale ultrasound. Journal of University Medical & Dental College1(1), 23-28.