Fetal brain imaging in fetuses at high risk of acquired anomalies

Title: Fetal brain imaging in fetuses at high risk of acquired anomalies

Ultrasonography and Magnetic Resonance Imaging (MRI) are techniques of which
the application is no longer limited to the examination of early and later
brain damege of the neonate since it can also successfully be applied in the
fetus. Despite this fact and the knowledge that the majority of early brain
damege does nog originate from peripartum events bur earlier before birth,
these techniques have nog yet been compared systemetically to examine the
prevalence of brain damage in fetuses at high risk. First it has to be examined
whether abnormal findings before birth persist with consequences for the later
neurological outcome, or are transient , due to the plasticity of the young
brain. Even physiological phenomena can be found mimicking sighns that may be
considered abnormal in the neonate.

Applicability of fetal brain imaging techniques for clinical purposes.

A pregnant woman will be invited for the study when the inclusion criteria are
fullfilled. After informed consent the study starts. The study consists of
fetal brain imaging of the pregnant women by means of transabdominal and
transvaginal sonography at inclusion and two weekly thereafter until birth.
MRI is performed once before birth. After birth the sonographic brain imaging
is repeated in the neonate and MRI is performed once at term age. Neurological
follow-up of the neonated is performed at term age, 1, 2, and 5 years.

The moment a pregnant women is exposed to a risk that may cause fetal brain
damage she is invited to participate in the study.

There is no risk involved in the participation of this study.
The nature of the study involves a longitudinal examination of the fetal brain
by means of sonographic examination until birth and once an MRI of the fetal
brain. The burden will be limited by combining the sonographic examinations
with the regular check-ups. The neonate will be examined sonographically within
24 hours after birth and weekly during the three weeks thereafter and one MRI
at term age. The neurological examination will be performed at term age, 1, 2,
and 5 years of age.
The benifit will be the continuity of the brain investigations by one
investigator and multidisciplinary team discussing the findings. In case of
unexpected findings the parents will be informed.