What Causes Non Visualization Of CSP In The Brain Of Fetus Indicate?

Posted on Wed, 25 Jun 2014

Question: I had my 20 week ultrasound yesterday....I am having twins....

Twin A looked great

Twin B they could not see the CSP in the brain....Can this be from the angle of the baby? How serious is this if it's not there? The lateral ventricles were also very slightly dialated....1.07 CM and 0.9-1.06 CM....is it still possible that brain is normal?

Also Baby should have measured 20 weeks but she measured 18 weeks 5 days....FL was only 2.7 CM, and her stomach is prominent...however, I have had free cell DNA test which came back with less than 1 in 10,000 chance on Trisomy 13, 18, and 21...shoud I still be concerned about these soft markers?

Answered by Dr. Dr. Rakhi Tayal (9 hours later)

Brief Answer:
Need further follow up scans.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
CSP is a marker for fetal neural maldevelopment. The septum is visible at 20 weeks. The non visualization is not likely to be related to the fetal position. It may not be associated with any ill effects on the baby. The slight dilatation of ventricles also needs to be closely monitored in the follow up scans.
The measurements of 18 weeks 5 days at 20 weeks is not worrisome yet. Such a slight difference in growth is normal in case of twins.
These parameters need to be followed up closely in a repeat scan after 2 weeks even if chromosomal abnormality has been ruled out after blood tests.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rakhi Tayal (6 hours later)

Is it possible that the CSP was not yet visible because the baby is measuring 18.5 weeks? Also they said that sonogram was difficult because they were close to my belly button and hard to see and there was dense tissue to go through as I have some extra weight in belly...would this effect sonogram results? Is it possible baby is ok if she doesn't have a CSP?

Also, if the mother is only 5 ft 1....is thigh bone still considered short or is it more normal.....if it grows a lot in further scans does that alleviate concern. Is this highly suspicicious of downs at this point?
Can an absent csp be caused by something that I did....I have had terrible morning sickness even with taking medication...can it cause brain to not form correctly....I have had an especially hard tone eating protein and some veggies...fruit is much asker to keep down. Very worried....if csp does not form, does that mean baby will have mental retardation?

Answered by Dr. Dr. Rakhi Tayal (3 hours later)

Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
It is possible that CSP was not visible due to a difficult position of the baby. It is visible at 18 weeks. An extra weight in the belly is not likely to affect the sonography much. The absence of CSP in most cases is associated with neuroanatomical anomalies that include agenesis of the corpus callosum, schizencephaly, septo-optic dysplasia, holoprosencephaly, chronic hydrocephalus and acquired fetal brain injury.
Fetal brain MRI scan will help in proper diagnosis if CSP is not visualized in follow up scans also. The absence of CSP is not related to anything that you did or ate. So worrying will not help.
The shorter length of femur is not so worrisome. It can grow later also. This is not suggestive of Down's.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar