Journal of Fetal Medicine

, Volume 5, Issue 4, pp 241–244 | Cite as

Detection of Open Spina Bifida in the First Trimester: Beyond Intracranial Translucency

  • Divya SinghEmail author
  • Amit Goyal
  • Ladbans Kaur
Brief Communication


Intracranial translucency (IT) has been used extensively as an indirect marker to exclude open spina bifida (OSB) in the first trimester. Like any sonographic sign, the use of IT is fraught with issues like non-visualization due to shadowing from bone, poor distinction from the adjacent hypoechoic brainstem, etc. In view of these challenges, researchers have come up with additional markers of OSB in the first trimester. The aim of this paper is to illustrate these sonographic clues so as to improve diagnostic accuracy in cases where obliteration of IT is equivocal.


Open spina bifida First trimester Intracranial translucency Signs 


  1. 1.
    Chaoui R, Benoit B, Mitkowska-Wozniak Heling KS, Nicolaides KH. Assessment of intracranial translucency (IT) in the detection of spina bifida at the 11–13-week scan. Ultrasound Obstet Gynecol. 2009;34:249–52.CrossRefPubMedGoogle Scholar
  2. 2.
    Solt I, Kim MJ, Acuna JG, Adeniji AB, Morales C, Rotmensch S. OC12.02: Spina bifida detection at 11–14 weeks: systematic analysis of technical factors associated with false-positive and false-negative image interpretation. Ultrasound Obstet Gynecol. 2010;36(S1):22.CrossRefGoogle Scholar
  3. 3.
    Finn M, Sutton D, Atkinson S, Ransome K, Sujenthrian P, Ditcham V, Wakefield P, Meagher S. The aqueduct of Sylvius: a sonographic landmark for neural tube defects in the first trimester. Ultrasound Obstet Gynecol. 2011;38:640–5.CrossRefPubMedGoogle Scholar
  4. 4.
    Chaoui R, Nicolaides KH. Detecting open spina bifida at the 11–13-week scan by assessing intracranial translucency and the posterior brain region: mid-sagittal or axial plane? Ultrasound Obstet Gynecol. 2011;38:609–12.CrossRefPubMedGoogle Scholar
  5. 5.
    Ushakov F, Everett T, Andreeva E, Tudorache S, Pandya P. P30.04: Crash sign: a marker for spina bifida at 11–13 weeks. Ultrasound Obstet Gynecol. 2016;48:267. Scholar
  6. 6.
    Lachmann R, Picciarelli G, Moratalla J, Greene N, Nicolaides KH. Frontomaxillary facial angle in fetuses with spina bifida at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol. 2010;36:268–71.CrossRefPubMedGoogle Scholar
  7. 7.
    Ramkrishna J, Araujo Junior E, White N, da Silva Costa F, Meagher S. P09.11: Maxillo-occipital line: a sonographic marker for the screening of open spina bifida in the first trimester. Ultrasound Obstet Gynecol. 2017;50:184.CrossRefGoogle Scholar

Copyright information

© Society of Fetal Medicine 2018

Authors and Affiliations

  1. 1.Prime Imaging and Prenatal DiagnosticsChandigarhIndia
  2. 2.City Scan CentreBathindaIndia

Personalised recommendations