Fetal cavum septum pellucidum nomogram and its relationship with fetal Doppler: a prospective study of a Turkish population

Year 2023, , 87 - 92, 12.01.2023

Burak Bayraktar , Cüneyt Eftal Taner

https://doi.org/10.32322/jhsm.1200856

Abstract

Aim: Septum pellucidum is a thin membrane with right and left leaves, and cavum septum pellucidum (CSP) is formed in the intermembrane region. This study investigates CSP nomogram dimensions for all trimesters in the Turkish population. In addition, the relationship between fetal Doppler flow and CSP size was investigated in this study.
Material and Method: This study was designed as a prospective cohort between 2019-2020. Pregnant women between 19-42 weeks who were followed up at University of Health Sciences Tepecik Training and Research Hospital, Department of Obstetrics and Gynecology were included in the study.
Results: A total of 517 fetuses meeting our criteria were included in this prospective study. In the second trimester (19-28 weeks) CSP width (4.12±0.88 vs. 4.91±1.42, p<0.001) and length (7.95±1.04 vs. 9.48±2.19, p<0.001) were significantly higher than in the third trimester (28-42 weeks). While the mean CSP width increased up to 32nd weeks, there was no clear increase-decrease pattern between 32nd-38th weeks, and it was observed to decrease after 38th weeks. The mean CSP length increased up to 29th weeks, while there was no clear increase-decrease pattern between 29th-38th weeks, but decreased after 38th weeks. While a significant correlation was observed between gestational week and CSP width (r=0.118, p=0.010), there was no significant correlation between CSP length (r=0.086, p=0.062). A significant correlation was observed between biparietal diameter (BPD) and CSP width (r=0.180, p<0.001) and length (r=0.202, p<0.001), but not with head circumference (HC). There was a significant correlation between middle cerebral artery (MCA) systolic/diastolic ratio (S/D) (r=0.185, p<0.001), pulsatility index (PI) (r=0.210, p<0.001) and resistive index (RI) (r=0.233, p<0.001) and CSP length, but not with CSP width.
Conclusion: Turkish population fetal CSP nomogram is presented in this study. Fetal middle cerebral artery Doppler measurements (S/D, PI, and RI) showing cerebral blood flow correlate with CSP length, but not with CSP width. There was no correlation between fetal umbilical artery Doppler measurements and CSP sizes. The results pave the way for population-based studies with much larger samples.

Keywords

Cavum septum pellucidum, nomogram, umblical artery, middle cerebral artery, Doppler

Project Number

Yoktur

References

• Nagaraj UD, Calvo-Garcia MA, Kline-Fath BM. Abnormalities associated with the cavum septi pellucidi on fetal MRI: what radiologists need to know. Am J Roentgenol 2018; 210: 989–97.
• Hosseinzadeh K, Luo J, Borhani A, Hill L. Non-visualisation of cavum septi pellucidi: implication in prenatal diagnosis? Insights Imaging 2013 ;4: 357–67.
• Erdemoğlu AK, Duman T. Kavum Septum Pellucidum Ve Kavum Vargae. Türkiye Klin Tıp Bilim Derg 1995; 15: 333–9.
• M Das J, Dossani RH. Cavum Septum Pellucidum. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Oct 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK537048/
• Raine A, Lee L, Yang Y, Colletti P. Neurodevelopmental marker for limbic maldevelopment in antisocial personality disorder and psychopathy. Br J Psychiatry 2010; 197: 186–92.
• American Institute of Ultrasound in Medicine. AIUM Practice Guideline for the performance of an antepartum obstetric ultrasound examination. J Ultrasound Med Off J Am Inst Ultrasound Med 2003; 22: 1116–25.
• Salomon LJ, Alfirevic Z, Berghella V, et al. ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2022; 59: 840–56.
• Salomon LJ, Alfirevic Z, Berghella V, et al. ISUOG Practice Guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2022;59: 840–56.
• Huang Y, Wang C, Tang D, Chen B, Jiang Z. Development and Validation of Nomogram-Based Prognosis Tools for Patients with Extremity Osteosarcoma: A SEER Population Study. J Oncol 2022; 2022: 9053663.
• Hj J, Mk S, Sc W, Sm C, Ch S, Fj H. Ultrasound measurement of the fetal cavum septi pellucidi. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol [Internet]. 1998 Dec [cited 2022 Nov 2]; 12.
• Onur, E, Alkın, T, Ada, E. The Relationship of Cavum Septum Pellucidum with Obssessive Compulsive Disorder and Tourette Disorder: A Case Report 2007; 10: 53-57.
• Wang LX, Li P, He H, et al. The Prevalence of Cavum Septum Pellucidum in Mental Disorders Revealed by MRI: A Meta-Analysis. J Neuropsychiatry Clin Neurosci 2020; 32: 175–84.
• Falco P, Gabrielli S, Visentin A, Perolo A, Pilu G, Bovicelli L. Transabdominal sonography of the cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancy: Fetal cavum septum pellucidum. Ultrasound Obstet Gynecol 2000; 16: 549–53.
• Tao G, Lu G, Zhan X, et al. Sonographic appearance of the cavum septum pellucidum et vergae in normal fetuses in the second and third trimesters of pregnancy. J Clin Ultrasound JCU 2013; 41: 525–31.
• Zhao D, Cai A, Wang B. An investigation of the standardization of fetal cavum septi pellucidi measurements using three-dimensional volumes of the fetal head. J Clin Ultrasound JCU 2019; 47: 331–8.
• Ho Y, Herrero T, Aguinaldo J, et al. Ultrasound measurements of frontal horns and the cavum septi pellucidi in healthy fetuses in the second and third trimesters of pregnancy. J Ultrasound Med Off J Am Inst Ultrasound Med 2020; 39: 127–37.
• Yakubu MA, Dambele M, Sidi M. Sonographic evaluation of the fetal cavum septi pellucidi dimension among antenatal women in Kano metropolis, NIGERIA. Nigerian Journal of Medical Imaging and Radiation 2021; 10: 8.
• Serhatlioglu S, Kocakoc E, Kiris A, Sapmaz E, Boztosun Y, Bozgeyik Z. Sonographic measurement of the fetal cerebellum, cisterna magna, and cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancy. J Clin Ultrasound JCU 2003; 31: 194–200.
• Arisoy R, Karatas S, Semiz A, Sanlıkan F, Yayla M. Cavum septum pellucidum nomogram during the second trimester of pregnancy. J Obstet Gynaecol J Inst Obstet Gynaecol 2022; 1–4.