Screening for neural tube pathology

Neural tube pathology is the most common fetal central nervous system pathology found on ultrasound with an incidence of 1:1000 per pregnancy. Neural tube pathology is often a malformation not suitable for life. Neural tube pathology refers to malformations of the skull and spine in which the neural tube has not closed during the embryonic period.

 

Examples of central nervous system pathologies potentially detected during early fetal ultrasound examination:

 

• Absence of brain/cranium;
• Cephalocele;
• Open spina bifida;
• Alobar holoprosencephaly - absence of the large hemispheres of the brain.

 

In recent years, the incidence of neural tube pathology has decreased due to increased awareness among pregnant women and the widespread prophylactic use of folic acid. It is important to consume at least 400 µg of folic acid per day from the 8th to the 12th. weeks before conception. Neural tube pathology occurs during the 3rd-5th period of fetal organogenesis. week of pregnancy, when a woman often does not know that she is pregnant. Unfortunately, half of the pregnancies are unplanned.

 

As part of the OSCAR test, early screening for neural tube pathology is carried out with a detailed assessment of the fetal skull, brain structures and spine. If, during the OSCAR test, there is a suspicion of a severe pathology of the fetal central nervous system, the ultrasound examination of the fetal central nervous system is repeated at the 16th or 20th week of pregnancy to clarify the diagnosis, if necessary.