Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 11 , ISSUE 3 ( July-September, 2017 ) > List of Articles

RESEARCH ARTICLE

Sonographic Transformation of Acrania to Anencephaly

Syed Amar Gilani, Iqra Manzoor

Keywords : Acrania,Anencephaly,Brain tissue,Hazy amniotic fluid,Polyhydramnios

Citation Information : Gilani SA, Manzoor I. Sonographic Transformation of Acrania to Anencephaly. Donald School J Ultrasound Obstet Gynecol 2017; 11 (3):189-196.

DOI: 10.5005/jp-journals-10009_1522

License: CC BY-NC 4.0

Published Online: 01-03-2016

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Objective

To ascertain that acrania can lead to anencephaly

Materials and methods

We commenced a cross-sectional study for a period of 41 months from 2013 to 2017. During routine ultrasound examination, we observed multiple cases of acrania in second trimester and third trimester. We followed 26 cases who failed to terminate their pregnancies and visited for reexamination. Changes in the brain matter, amniotic fluid volume, and echogenicity of the acrania fetuses were recorded and compared with the previous examination. Development of anencephaly was correlated with maternal age and advancement of gestational age. All the patients were examined transabdominally according to the American Institute of Ultrasound in Medicine (AIUM) guidelines for obstetrical ultrasound. Data were collected from the previous report and recent examination, by evaluating data with the help of IBM Statistical Package for the Social Sciences (SPSS) version 24 package, and the results were summarized.

Results

Pregnant women with diagnosed acrania fetus visited second time with a lapse of more than 4 weeks and were enrolled with mean age 25.73 ± 8.80. We observed 4 (15.4%) acrania patients developed into anencephaly. Development of anencephaly was observed to be correlated with the advancement of gestational age. It was observed that acrania is more common in below 20 and above 30 age groups. Haziness of amniotic fluid is also observed to be related with acrania.

Conclusion

Anencephaly could be caused by multiple factors but acrania can lead to anencephaly with continuous exposure of brain matter and meninges to mechanical trauma and chemical activities of the amniotic fluid.

Clinical significance

To test the hypothesis of acrania to anencephaly and make a roadmap for upcoming researches on association of acrania with physical, environmental, and genetical factors.

How to cite this article

Bacha R, Gilani SA, Manzoor I. Sonographic Transformation of Acrania to Anencephaly. Donald School J Ultrasound Obstet Gynecol 2017;11(3):189-196.


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  1. Textbook of diagnostic sonography. Elsevier Health Sciences; 2017.
  2. Donald school textbook of ultrasound in obstetrics and gynecology. 3rd ed. Jaypee Brothers, Medical Publishers Pvt. Limited; 2011. p. 249
  3. Three-and four-dimensional HDlive rendering image of fetal acrania/exencephaly in early pregnancy. J Med Ultrasonics 2013;40(3):271-273.
  4. Prevalence of central nervous system malformations in Egypt: a hospital-based study. J Evidence Based Women's Health J Soc 2016 Aug;6(3):106-109.
  5. Anencephaly and coexisting malformations: analysis of 35 cases. PERINATAL 2015 Dec;23(3):175-179.
  6. Prenatal ultrasound diagnosis of neural tube defects. Pictorial essay. Med Ultrason 2012 Jun;14(2):147-153.
  7. Demographic factors and associated anomalies in fetuses with neural tube defects. Pteridines 2013 Dec;24(3-4):257-263.
  8. Acrania induced by anencephaly. Anat Rec 1951;111(4):653-667.
  9. Lethal developmental defects: an overview. Open J Obstet Gynecol 2014;4(16): 1006.
  10. Sonoembryology and early prenatal diagnosis of neural anomalies. Prenatal Diagn 2009 Apr;29(4):312-325.
  11. Fetology: diagnosis and management of the fetal patient, 2n ed. New York: McGraw-Hill Education; 2010. p. 1056
  12. Characteristics of fetuses evaluated due to suspected anencephaly: a population-based cohort study in southern Brazil. Sao Paulo Med J 2015 Mar-Apr;133(2):101-108.
  13. Ultrasound screening for anencephaly at 10.14 weeks of gestation. Ultrasound Obstet Gynecol 1997 Jan;9(1):14-16.
  14. Antenatal diagnosis of anencephaly to determine the prevalence and its correlation with folic acid deficiency by using peripheral blood picture in District Poonch, Azad Kashmir. Methods 2015.
  15. Maternal age and neural tube defects: evidence for a greater effect in spina bifida than in anencephaly. Rev Med Chil 2005 Jan;133(1):62-70.
  16. First]trimester echogenic amniotic fluid in the acrania-anencephaly sequence. J Ultrasound Med 2003 Oct;22(10):1075-1079.
  17. Associated malformations among infants with neural tube defects. American J Med Genet Part A 2011 Feb;155(3):565-568.
  18. Anencephaly and its associated anomalies in antenatal scans. J Evid Based Med Healthc 2016; 3(23):1033-1035.
  19. 3D/4D sonography moved prenatal diagnosis of fetal anomalies from the second to the first trimester of pregnancy. Taylor & Francis; 2012.
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