Perinatal Management of Central Nervous System Disorder

概要

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With the improvement of ultrasonography, we can easily detect congenital anomalies of the fetuses, particularlly the central nervous system disorder. Identification of such cases can be extremely helpful in clinical management.<BR>We have managed 20 cases of fetal central nervous system disorder in the last 8 years. There were 6 cases of holoprosencephaly, 2 cases of meningocele, 2 cases of meningomyelocele, 1 case of meningoencephalocele, 2 cases of Dandy-Walker cyst, 1 casee of agenesis of corpus callosum, 1 case of arachnoid cyst, 1 case of microcephaly, and 4 cases of anencephaly. In all these cases, the abnormalities were detected prenatally and 90 percent of cases were correctly diagnosed in primary diagnosis by ultrasonography.<BR>With the additional assestance of color flow mapping and MRI, we prenatally diagnosed and treated these cases. In our institute the cases of anen cephaly and holoprosencephaly with cyclopia were absolutely hopeless cases, and were terminated. We watched the other cases carefully. The one month survival rate of these cases, (excluding the 7 terminated cases) was 9/13. And their outcomes were as following: no handicap: 2; mild handicap: 2; moderate handicap: 2; severe handicap: 3. In addition, we present a pilot study of transabdominal head-compression test (changing MCA flow wave form analysis) in order to detect the fetal CNS disorders.
日本脳神経超音波学会の論文