Insights into neurosonographic indicators for prenatal diagnosis of fetal neurological anomalies and cortical development: A systematic review of the literature

Abstract

Background

Congenital defects of the central nervous system are the second cause of disability in childhood, representing up to 20 % of structural malformations diagnosed prenatally. The accurate prenatal diagnosis of fetal neurological anomalies and the assessment of cortical development are critical for early intervention and improved long-term outcomes. Neurosonography plays a vital role in this process, providing detailed insights into the structural and functional development of the fetal brain. This systematic review aims to synthesize current knowledge on neurosonographic indicators for prenatal diagnosis, with a special focus on cortical development and its impact in cases of fetal growth defects.

Material and methods

We conducted a comprehensive search for primary literature in PubMed database were searched for English and Spanish-language, peer-reviewed literature published in the last 15 years. Additional articles were identified by scrutinizing others search platforms (Cochrane Library, UpToDate). Inclusion criteria were single pregnancy and no known feto-maternal pathologies at the beginning of the study.

Results

Of the 361 published abstracts identified, 35 met criteria for inclusion. The review highlighted the importance of detailed neurosonographic assessments, including the evaluation of cerebral fissures such as the Sylvian fissure, parieto-occipital fissure, and calcarine fissure. Targeted ultrasound techniques were found to provide comprehensive insights comparable to fetal magnetic resonance imaging. We underscored the significant impact of intrauterine growth restriction on cortical development, with early intervention being crucial. Genetic and congenital infection screenings were emphasized as essential components of prenatal assessment.

Conclusion

The assessment of fetal brain maturation patterns according to gestational age allows us to rule out a delay in cortical development. The heterogeneity of methods and evaluable parameters in fetal neurodevelopment makes it necessary to standardize the evaluation of the main structures of interest both for screening and for the diagnosis of cortical development anomalies, even with the aim of trying to improve upgrade prognostic advice.