Use of fetal magnetic resonance imaging in patients electing termination of pregnancy by dilation and evacuation.

Abstract

The purpose of this study was to determine whether magnetic resonance imaging of the fetal brain before dilation and evacuation enhances diagnosis when equivocal ultrasound findings and disrupted autopsy specimens exist. Patients with equivocal fetal brain abnormalities on ultrasound examination who were considering termination of pregnancy were evaluated retrospectively. Abdominal and pelvic magnetic resonance imaging was performed for further evaluation, and orthogonal fetal brain images were obtained. A multidisciplinary team reviewed all cases and discussed the findings, possible causes, and recurrence risks with each patient. Seven patients with fetal brain anomalies underwent magnetic resonance imaging before dilation and evacuation. Magnetic resonance imaging diagnoses included intracranial hemorrhages, semilobar holoprosencephaly, intracranial teratoma, multiple cerebral infarcts, and unilateral cerebellar hypoplasia. In all cases, magnetic resonance imaging provided valuable information and helped distinguish possible genetic syndromes from likely sporadic disorders of brain development. Magnetic resonance imaging can provide insight into diagnosis, cause, and recurrence risks for patients who choose dilation and evacuation because of fetal brain abnormalities.