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Informal Case: Exencephaly –From: Terry J. DuBose (duboseterryj@uams.edu)Thu Oct 9 10:10:24 2003
Re: http://www.obgyn.net/us/us.asp?page=/us/cotm/0006/Exencephaly-Anencephaly There is an excellent article that also documents the change from Exencephaly to Anencephaly with images in the current JUM. See: http://www.jultrasoundmed.org/cgi/content/full/22/10/1075 Unfortunately, this article did not reference our earlier publication of the same type of series with images... I guess electronic peer-review and publication just doesn't count. If it isn't in Medline it doesn't count. :-( However the article title raises an academic question for me. According to my handy-dandy Stedman's Electronic Medical Dictionary "Acrania" and "Exencephaly" are very similar if not the same... so is there a difference in the two terms and how they should be used? Thanks, Terry J Ultrasound Med 22:1075-1079 • 0278-4297 http://www.jultrasoundmed.org/cgi/content/full/22/10/1075 Case Series First-Trimester Echogenic Amniotic Fluid in the Acrania-Anencephaly Sequence By Daniel Cafici, MD and Waldo Sepulveda, MD Ultrasound and Prenatal Diagnosis Unit, Ecodiagnostico Alem, Buenos Aires, Argentina (D.C.); and Fetal Medicine Center, Department of Obstetrics and Gynecology, Clinica Las Condes, Santiago, Chile (W.S.). Abstract Objective. To describe the association between echogenic amniotic fluid and first-trimester fetal acrania. Methods. Nine fetuses with acrania were examined between 11 weeks’ and 13 weeks 6 days’ menstrual age for the presence of echogenic free-floating particles in the amniotic fluid. Cases were classified into 3 types according to the echogenicity of the amniotic fluid: similar to (type 0), slightly greater than (type 1), and clearly more echogenic than (type 2) that of the extracelomic fluid. Results. In 1 pregnancy, no free-floating particles were identified (type 0). In 6 cases, small free-floating particles scattered within the amniotic cavity were identified, making the amniotic fluid slightly more echogenic than the extracelomic fluid (type 1). In the remaining 2 cases, the amniotic fluid was homogeneously and clearly more echogenic than the extracelomic fluid (type 2). Conclusions. A high percentage (89%) of fetuses with acrania had echogenic amniotic fluid, suggesting that this finding could potentially be used as a marker of fetal acrania in the first trimester. This finding also supports the hypothesis of the transition from acrania to anencephaly, with the unprotected brain undergoing progressive destruction from the first trimester, leading to the classic finding of anencephaly in the second trimester. Key Words: acrania • anencephaly • fetal sonography • first trimester • prenatal diagnosis
-- Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM Assistant Professor & Director, Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, CHRP 4301 West Markham St. Mail Slot #563 Little Rock, Arkansas, 72205 USA 501-686-6510 DuBoseTerryJ@UAMS.edu http://www.io.com/~dubose/ http://www.uams.edu/chrp/dms/default.asp http://www.obgyn.net/us/panel/panel.htm
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