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Kfar Saba, Israel

Farkas N.,The Academic College of Tel-Aviv-Yaffo | Hoffmann C.,Neuroradiology Unit | Hoffmann C.,Tel Aviv University | Ben-Sira L.,Tel Aviv University | And 11 more authors.
Prenatal Diagnosis | Year: 2011

Objective: We evaluated the neuropsychological outcome of children with proven congenital cytomegalovirus (CMV) infection and normal consecutive fetal neurosonographic examinations. Methods: We retrospectively reviewed laboratory and imaging findings of children with congenital CMV infection. The study group consisted of children with a positive polymerase chain reaction (PCR) in amniotic fluid and virus isolation in urine in the first week of life, and normal fetal ultrasonographic (US) examination findings, including a normal multiplanar neurosonographic evaluation. Patients with abnormal magnetic resonance (MR) findings were not excluded. The study and control groups were evaluated for cognitive, language, and motor development at one follow-up examination conducted at 11-81 months of age. Results: Children with congenital CMV infection and normal fetal brain findings in the US examination did not differ from the control group in terms of cognitive, language, motor, emotional-behavioral, and executive functioning. There were no differences between congenitally infected children who had a normal fetal brain MR examination and children whose fetal brain MR examination raised suspicion of a possible brain insult. Conclusions: Normal neurosonographic examinations during pregnancy appear to predict a normal early neuropsychological outcome in fetuses with congenital CMV infection. Outcome did not correlate with suspected abnormal white matter on fetal MR imaging. Copyright © 2011 John Wiley & Sons, Ltd. Source

Malinger G.,Wolfson Medical Center | Malinger G.,Edith Wolfson Medical Center | Malinger G.,Tel Aviv University | Lev D.,Wolfson Medical Center | And 19 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2011

Objectives To compare the outcomes of fetuses with apparently isolated macrocephaly and those with associated findings, and to compare prenatal findings with postnatal diagnoses in children with syndromic macrocephaly. Methods We reviewed the files of all patients referred for suspected fetal macrocephaly, during a 10-year period from 2000, to a large prenatal diagnosis unit with expertise in fetal neurology counseling. Macrocephaly was defined as head circumference (HC) > 2 SDs of the norm. Patients with confirmed HC > 2 SD were identified and contacted, and their development was evaluated. Results Adequate data for analysis were available for 98 patients, in 82 of whom the fetal macrocephaly was considered isolated (Group A), and in 16 of whom associated fetal anomalies were identified (Group B). Macrocephaly was diagnosed earlier in Group B patients (28.4 vs. 32.3 weeks, P = 0.069), and the HC in Group B patients was larger (Z-score 2.95 vs. 2.3, P < 0.001). From Group A there were 81 liveborn; one of whom was diagnosed as having infantile autism. From Group B, there were nine liveborn. The associated central nervous system findings, as demonstrated by ultrasound and magnetic resonance imaging, included mild ventriculomegaly, malformations of cortical development, callosal abnormalities, overdeveloped sulcation, large cavum septi pellucidi, large subarachnoid spaces, mega cisterna magna, periventricular pseudocyst, open operculum and vermian dysgenesis. Syndromic diagnosis was made in utero in five fetuses and after birth in three. In eight patients, associated malformations were confirmed after birth but a specific diagnosis was not reached. Conclusions When fetal macrocephaly is associated with other brain or systemic anomalies, syndromic macrocephaly can be diagnosed in utero. Fetuses with syndromic macrocephaly have a significantly larger HC, usually > 2.5 SD above the mean. Isolated macrocephaly, particularly when the HC is < 2.5 SD above the norm, may be clinically benign. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. Source

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