2010-10-05-14 Spina bifida with myelomeningocele © Cerekja www.TheFetus.net
Spina bifida with myelomeningocele
* Ultrasound Division, ASL Roma B, Rome, Italy.
Albana Cerekja, MD, PhD.*, Juan Piazze MD, PhD.**
** Ultrasound Division, Ceprano Hospital, Ceprano, Italy.
This is a case of a 28-year-old patient G1 P0 with non-contributive personal and family history. She had no history of drug abuse in the first trimester. First ultrasound examination performed at 13 weeks was unremarkable and fetal biometry was consistent with length of amenorrhea.
Ultrasound scan at 20 weeks detected a spinal defect, myelomeningocele, at lumbo-sacral level. Surprisingly, there were no other findings secondary to the spinal defect, no lemon sign or banana sign – Arnold Chiari type II, no ventriculomegaly.
The patient was referred to the tertiary center which confirmed our diagnosis of myelomeningocele with spina bifida. Parents opted for pregnancy termination after an extensive genetic counseling.
Images 1,2: Sagittal view of the spine showing a defect at the lumbo-sacral region (arrow)
Images 3,4: Image 3 shows coronal scan of the spinal defect (arrow). Image 4 shows a transverse view of the defect of the vertebral arch with protruding spinal cord.
Images 5,6: Image 5 shows a transverse view of the meningomyelocele. Image 6 shows a coronal view of the herniated cystic structure containing spinal cord.
Images 7: Axial view of the fetal head, note normal cerebellum and posterior fossa.
Videos 1- 4: Videso showing spinal defect in coronal, sagittal and transverse view.