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Imaging of Fetal Anomalies

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Evidence-Based Imaging in Pediatrics

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Abstract

■ Routine ultrasound in early pregnancy (before 24 weeks gestation) is useful for gestational age assessment, identification of multiple pregnancies, and identification of unsuspected fetal anomalies (strong evidence).

■ Routine ultrasound in late pregnancy (after 24 weeks gestation) may not be associated with improvements in overall perinatal mortality though there is a lack of data with regard to long-term neurodevelopmental outcome (moderate evidence).

■ High-risk pregnancies benefit from ultrasound assessment including Doppler ultrasound of umbilical and fetal vessels in late pregnancy with a trend in reduction of perinatal deaths (moderate to strong evidence).

■ The accuracy of ultrasound in the evaluation of fetal anomalies is influenced by the skill of the sonographer, quality of equipment, prevalence of a defect, gestational age of the fetus, maternal body habitus, oligohydramnios, and examination protocol (moderate evidence).

■ MRI evaluation of fetal abnormalities is not limited by fetal lie, oligohydramnios, overlying fat, bone, or air (moderate evidence).

■ MRI can be a useful adjunct in the evaluation of certain fetal anomalies particularly within the brain and chest (limited evidence).

■ No data were found in the medical literature that evaluated the cost-effectiveness of US versus MR in the evaluation of fetal anomalies (limited evidence).

■ MRI using higher strength magnets (≥3 T) and Doppler ultrasound in the first trimester should be minimized due to theoretical risks (US moderate evidence, MRI limited evidence).

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Authors and Affiliations

  1. Department of Diagnostic Imaging and Radiology, George Washington University School of Medicine and Health Sciences, Children’s National Medical Center, 20010, Washington, DC, USA

    Dorothy I. Bulas

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  1. Dorothy I. Bulas
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Correspondence to Dorothy I. Bulas .

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Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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Bulas, D.I. (2010). Imaging of Fetal Anomalies. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_41

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