This video shows Fetus with Polyhydromnios and Encephalocele.
An encephalocele (in-sef-a-luh-seal) is a rare disorder in which the bones of the skull do not close completely. This creates a gap through which cerebral spinal fluid, brain tissue, and the meninges (the membrane that covers the brain) can protrude into a sac-like formation.
An encephalocele forms when the neural tube does not close properly during gestation. A neural tube is a narrow channel that folds and closes to form the brain and spinal cord. The exact cause, however, is unknown. It usually occurs among families with a history of spina bifida and anencephaly.
Ultrasound images of the fetus can reveal the presence of a herniated, fluid-filled sac outside the skull. Encephaloceles that go undetected during gestation usually are diagnosed at birth by observation of the deformity.
Sometimes encephaloceles are detected during a routine prenatal ultrasound, at as early as 13 weeks' gestation. If an encephalocele is suspected on an ultrasound, a fetal MRI can provide all the detail necessary to confirm the diagnosis.
Symptoms of an encephalocele
Neurologic problems.
Hydrocephalus: Cerebrospinal fluid accumulated in the brain.
Spastic quadriplegia: Paralysis of the limbs.
Microcephaly: An abnormally small head.
Ataxia: Uncoordinated muscle movement.
Developmental delay.
Vision problems.
Mental and growth retardation.
Encephaloceles are usually dramatic deformities diagnosed immediately after birth, but occasionally a small encephalocele in the nasal and forehead region can go undetected. There is a genetic component to the condition; it often occurs in families with a history of spina bifida and anencephaly in other family members.
Babies with a frontal encephalocele, no associated syndrome or defects, and no brain tissue herniating into the sac have a good chance of survival. Babies with an encephalocele at the back of the head have a 55 percent survival rate.
The remaining brain tissue is often exposed (not covered by bone or skin). Affected babies are usually blind, deaf, unconscious, and unable to feel pain. Almost all babies with anencephaly die before birth, although some may survive a few hours or a few days after birth.
Babies with an encephalocele at the back of the head have a 55 percent survival rate. The long-term prognosis for survival becomes less likely if there are other complications, such as associated defects or syndromes or if brain tissue protrudes into the sac.
Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In spina bifida, the fetal spinal column doesn't close completely.
pregnancy after encephalocele
Hydrops fetalis is severe swelling (edema) in an unborn baby or a newborn baby. It is a life-threatening problem. Hydrops develops when too much fluid leaves the baby's bloodstream and goes into the tissues.
Of those fetuses with anencephaly, a small portion will die while still in the uterus (intrauterine fetal demise or stillbirth). Approximately 25% will have excessive amniotic fluid around the fetus (polyhydramnios). Polyhydramnios may cause extra stretching of the uterus resulting in preterm contractions.
If the initial ultrasound shows evidence of polyhydramnios, sonologist will be requested to do a more detailed ultrasound. Measurement of the amniotic fluid volume (AFV) by measuring the single largest, the deepest pocket of fluid around the baby. An AFV value of 8 centimeters or more suggests polyhydramnios.
The vertical measurement of the deepest pocket of amniotic fluid free of fetal parts is used to classify polyhydramnios into mild (8-11 cm), moderate (12-15 cm), and severe (≥16 cm). In about 80% of cases, the polyhydramnios is mild, in 15% moderate, and in 5% severe.
Common causes of polyhydramnios include gestational diabetes, fetal anomalies with disturbed fetal swallowing of amniotic fluid, fetal infections, and other, rarer causes. The diagnosis is obtained by ultrasound.
Impact of Polyhydramnios on pregnancy
Most women with polyhydramnios will deliver healthy babies with no problems. If polyhydramnios is severe, it may make your uterus contract. You may also find it difficult to get comfortable in a chair or lying down.
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