Can prenatal ultrasound findings predict ambulatory status in fetuses with XXXX ?

@entity1 @entity1276 @entity5149 @entity1514 @entity14526
OBJECTIVE: To determine whether prenatal sonographic findings in fetuses with @entity14526 can predict ambulatory potential and the need for postnatal shunt placement. STUDY DESIGN: Ongoing pregnancies complicated by isolated @entity14526 from January 1996 to March 2000 were studied retrospectively. Static images and reports generated every 3-4 weeks from diagnosis until delivery were reviewed for lesion level and type, ventricular width, and lower extremity appearance. Operative summaries as well as neonatal and pediatric charts were reviewed. Ambulatory was defined in @entity1 > or =2 years old as walking with or without appliances. In those <2 years of age, ambulatory was defined as at least 4/5 lower extremity muscle strength. RESULTS: Thirty-three cases of isolated @entity14526 were identified. Lower (more caudal) lesion levels and smaller ventricular size were associated with ambulatory status in univariate analyses (P <.001, P =.003, respectively). No @entity1 with a @entity1514 was ambulatory (n = 11); all had @entity1276 diagnosed prenatally and all required shunt placement. In contrast, all @entity1 with L4-sacral lesions (n = 10) were ambulatory, and 60% had @entity1276 diagnosed prenatally. Of @entity1 with L1-L3 lesions (n = 12), 50% were ambulatory. In this group, ambulatory potential could not be determined by the presence of @entity1276 , ventricular size, or the presence of @entity5149 . In the entire cohort, no @entity1 with a myeloschisis was ambulatory, and all @entity1 except one with a sacral lesion required postnatal shunt placement. CONCLUSIONS: Sonographic determination of lesion level and type is useful in predicting the ambulatory potential of fetuses with @entity14526 .
