Ante-natal Counseling

I offer parents of children with inuteroabnormalities prenatal counseling. This allows us to provide education toprospective parents about their child's diagnosis and prognosis, allowing themmaking important decisions about the pregnancy and new born. Disordersdiagnosed in utero include hydrocephalus, intracranial cyst, spinal dysraphism,vascular anomalies, and rarely, tumors.

What Is Prenatal Hydrocephalus?
Prenatal hydrocephalus describes hydrocephalus that is diagnosed in utero (before birth).

Hydrocephalus can be detected in a fetus as early as the latter part of the first trimester of pregnancy. Around 20 to 24 weeks of gestation, abnormal dilation of the fetus's ventricles is more clearly detectable. Prenatal ultrasound, performed by a radiologist skilled in obstetric ultrasound, is highly reliable and accurate. It will establish that there is an abnormal cerebrospinal fluid (CSF) collection but it may not show the precise site of flow obstruction. The more important question is what caused the hydrocephalus and to what degree is there other malformations within the central nervous system. Amniocentesis (needle aspiration of intrauterine fluid) can often detect the presence of open neural tube defects, such as myelomeningocele, chromosome abnormalities and in utero infections, and may indicate the severity of the fetal condition. In general, early (first trimester) development of significant hydrocephalus can be a bad prognostic sign for infant mortality and developmental progress. In some cases, mild ventricular dilation identified by ultrasound has resolved itself by the third trimester.

Prenatal hydrocephalus is generally not treated until after birth, After birth a shunt may be inserted into the baby's brain to divert CSF fluid to treat the hydrocephalus.

There are many unknowns surrounding a prenatal diagnosis of hydrocephalus. This can be very frightening, distressing and sad for expectant parents, and extremely frustrating for the medical specialists who provide care. Although the outlook and success rate for infants diagnosed at or after birth is generally very high, there are limited studies available on the long-term prognosis of those with prenatal-onset hydrocephalus. Much seems to depend on the extent of associated brain and systemic abnormalities, structural changes in the brain and the extent of the hydrocephalus. It is very difficult to accurately predict future function based on morphology or imaging. The more significant factor in the future development of children with prenatal-onset hydrocephalus is the presence of continuing care and the absence of complications such as infection or hemorrhage.

I also do antenatal counseling for cyst in brain like Dandy-Walker malformation, Arachnoid cyst and spinal dyrasphism.

DISEASE &
TREATMENTS

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