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Patelli C, Berti G, Marra MC, Lu JLA, Resta S, Mappa I, Rizzo G. Modeling fetal cavum septum pellucidi width by quantile regression at 18-34 weeks of gestation: A prospective cross-sectional study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1466-1471. [PMID: 37548058 DOI: 10.1002/jcu.23533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Develop charts for cavum septum pellucidi (CSP) following a standardized methodology and using quantile regression. The secondary objective was to assess the influence of fetal gender on the generated reference curves. METHODS In a cross-sectional prospective study 453 low-risk singleton pregnancies were evaluated at a gestational age interval between 18 and 34 weeks. The width of CSP were measured on ultrasound images using a standardized technique and their changes were evaluated by quantile regression as a function of gestational age (GA) interval or head circumference (HC). Differences between sex were evaluated. RESULTS The measurement of CSP significantly increased with gestation and HC. Linear models better described the changes of CSP with GA and HC. The fits of CSP width with GA and HC were not significantly different. Male fetuses showed significantly higher CSP width when compared to female fetuses (u = 2.973; p = 0.005). CONCLUSIONS We generated prospective nomograms of fetal CSP development using quantile regression and following a strict standardized methodology. These new charts may be useful to better identify abnormal cases at higher risk of associated anomalies. Further our findings underline the potential effect of gender in developing fetal brain.
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Affiliation(s)
- Chiara Patelli
- Department of Obstetrics and Gynecology, Università diVerona, Verona, Italy
| | - Giorgia Berti
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Maria Chiara Marra
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Jia Li Angela Lu
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Serena Resta
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Ilenia Mappa
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
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Fantasia I, Ciardo C, Bracalente G, Filippi E, Murru FM, Spezzacatene A, Bin M, Mendez Quintero O, Montaguti E, Lees C, Papanikolaou K, Pilu G, Prefumo F, Thilaganathan B, Stampalija T. Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance. Acta Obstet Gynecol Scand 2023; 102:744-750. [PMID: 37059118 DOI: 10.1111/aogs.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/28/2023] [Accepted: 03/28/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION The objective of this study was to describe a cohort of fetuses with an ultrasound prenatal diagnosis of obliterated cavum septi pellucidi (oCSP) with the aim to explore the rate of associated malformations, the progression during pregnancy and the role of fetal magnetic resonance imaging (MRI). MATERIAL AND METHODS This was a retrospective multicenter international study of fetuses diagnosed with oCSP in the second trimester with available fetal MRI and subsequent ultrasound and/or fetal MRI follow-up in the third trimester. Where available, postnatal data were collected to obtain information on neurodevelopment. RESULTS We identified 45 fetuses with oCSP at 20.5 weeks (interquartile range 20.1-21.1). oCSP was apparently isolated at ultrasound in 89% (40/45) and fetal MRI found additional findings in 5% (2/40) of cases, including polymicrogyria and microencephaly. In the remaining 38 fetuses, fetal MRI found a variable amount of fluid in CSP in 74% (28/38) and no fluid in 26% (10/38). Ultrasound follow-up at or after 30 weeks confirmed the diagnosis of oCSP in 32% (12/38) while fluid was visible in 68% (26/38). At follow-up MRI, performed in eight pregnancies, there were periventricular cysts and delayed sulcation with persistent oCSP in one case. Among the remaining cases with normal follow-up ultrasound and fetal MRI findings, the postnatal outcome was normal in 89% of cases (33/37) and abnormal in 11% (4/37): two with isolated speech delay, and two with neurodevelopmental delay secondary to postnatal diagnosis of Noonan syndrome at 5 years in one case and microcephaly with delayed cortical maturation at 5 months in the other. CONCLUSIONS Apparently isolated oCSP at mid-pregnancy is a transient finding with the visualization of the fluid later in pregnancy in up to 70% of cases. At referral, associated defects can be found in around 11% of cases at ultrasound and 8% at fetal MRI indicating the need for a detailed evaluation by expert physicians when oCSP is suspected.
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Affiliation(s)
- Ilaria Fantasia
- Unit of Fetal Medicine, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Claudia Ciardo
- Department of Gynecology and Obstetrics, Ospedale Fracastoro, San Bonifacio, Italy
| | | | - Elisa Filippi
- UOC Gynecology and Obstetrics, Ospedale Cà Foncello Treviso, Treviso, Italy
| | - Flora Maria Murru
- Radiology Service, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Anita Spezzacatene
- Radiology Service, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Maura Bin
- Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Elisa Montaguti
- Obstetric Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Christoph Lees
- Centre for Fetal Care, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Katherine Papanikolaou
- Centre for Fetal Care, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Gianluigi Pilu
- Obstetric Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Federico Prefumo
- Obstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Tamara Stampalija
- Unit of Fetal Medicine, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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