First trimester detection of fetal open spina bifida using BS/BSOB ratio

Angelo Sirico, Antonio Raffone, Antonio Lanzone, Gabriele Saccone, Antonio Travaglino, Laura Sarno, Giuseppe Rizzo, Gianluca Rizzo, Fulvio Zullo, Giuseppe Maria Maruotti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)


Background: Despite the well-known second trimester ultrasound signs, current possibilities of in utero surgical repair of open spina bifida require a timely detection of the spine defect. Objective: To evaluate the diagnostic accuracy of the ratio between brain stem (BS) diameter and its distance to the occipital bone (BSOB) (BS/BSOB ratio) in the detection of fetuses with open spina bifida at first trimester ultrasound. Methods: A systematic review and meta-analysis of diagnostic accuracy was performed by searching seven electronic databases from their inception to February 2019 for all studies assessing the association between BS/BSOB ratio and diagnosis of spine bifida. Diagnostic accuracy of BS/BSOB ratio in prenatal diagnosis of spine bifida was assessed as sensitivity, specificity, positive and negative likelihood ratios (LR + and LR−), and area under the curve (AUC) on SROC curves. Results: Four studies, including 17,598 fetuses with 23 cases of open spina bifida, were included in the meta-analysis. BS/BSOB ratio showed pooled sensitivity of 0.70 (95% CI 0.47–0.87; I2 = 78.3%), specificity of 1.00 (95% CI 0.99–1.0; I2 = 99.2%), LR + and LR− of 51.44 (95% CI 9.53–277.64; I2 = 85.5%) and 0.23 (95% CI 0.04–1.17; I2 = 64.8%), respectively, and an AUC of 0.9649. Conclusion: First trimester BS/BSOB ratio has a high diagnostic accuracy in detecting fetuses with open spina bifida.
Lingua originaleEnglish
pagine (da-a)333-340
Numero di pagine8
RivistaArchives of Gynecology and Obstetrics
Stato di pubblicazionePubblicato - 2020


  • Brain Stem
  • Female
  • Fetus
  • First trimester
  • Gestational Age
  • Humans
  • Meningomyelocele
  • Myelomeningocele
  • Occipital Bone
  • Pregnancy
  • Pregnancy Trimester, First
  • Prenatal Care
  • Prenatal Diagnosis
  • Sensitivity and Specificity
  • Spina Bifida Cystica
  • Spina bifida
  • Spinal Dysraphism
  • Tailored medicine
  • Ultrasonography, Prenatal
  • Ultrasound


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