First-Trimester Echogenic Amniotic Fluid in the Acrania-Anencephaly Sequence

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. Case...

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Bibliographic Details
Published in:Journal of ultrasound in medicine 2003-10, Vol.22 (10), p.1075-1079
Main Authors: Cafici, Daniel, Sepulveda, Waldo
Format: Article
Language:English
Subjects:
acrania
Amniotic Fluid - diagnostic imaging
anencephaly
Anencephaly - diagnostic imaging
Biological and medical sciences
Female
fetal sonography
first trimester
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Management. Prenatal diagnosis
Medical sciences
Neural Tube Defects - diagnostic imaging
Pregnancy
Pregnancy Trimester, First
Pregnancy. Fetus. Placenta
prenatal diagnosis
Ultrasonography, Prenatal
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Description
Summary: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.
ISSN:0278-4297
1550-9613
DOI:10.7863/jum.2003.22.10.1075