Magnetic resonance imaging (MRI) helps detect nervous system defects and abnormalities in the fetus’s chest, from which doctors can have effective intervention methods during and after birth.
MRI uses a large magnet, radio frequency pulses and a computer to simulate images of the fetus in the womb. This technique is non-invasive, providing information and clear images of the anatomical structure of the fetus.
On June 20, La Hong Chau, M.D., Head of Obstetrics and Gynecology Imaging Unit, Center for Diagnostic Imaging and Interventional Radiology, Tam Anh General Hospital, Ho Chi Minh City, said that MRI uses magnetic fields. Instead of radiation (X-rays) to comprehensively detect abnormalities in the brain, spine, face, neck, chest, lungs, abdomen, pelvis (including intestines, kidneys and bladder), placenta structure. ..
In fetal imaging diagnosis, ultrasound and other tests are the basic methods of detecting fetal abnormalities. However, nervous system defects are difficult to detect accurately. At this time, MRI technology helps accurately diagnose fetal defects, especially central nervous system defects. MRI is usually performed in the second or third trimester of pregnancy after abnormal fetal test or ultrasound results.
This method also overcomes the limitations of ultrasound including ossification of the skull vault, unfavorable fetal position and low amniotic fluid. MRI also allows the examination of structures in areas that are difficult to reach with ultrasound, such as the retrobulbar, the skull base including the petrous bones, the semicircular canals, the cochlea, and the optic chiasm.
Doctors also prescribe MRI scans for cases where ultrasound diagnosis is difficult, such as maternal obesity, unfavorable fetal position, oligohydramnios, anhydramnios… MRI results provide additional information. diagnostic information for complex malformations. From there, the doctor evaluates whether it is possible to keep the pregnancy or terminate the pregnancy, and recommends postpartum intervention methods.
“In many cases, MRI has better diagnostic effectiveness than ultrasound, X-ray or CT,” Dr. Chau said, citing research published in a medical journal. The Lancet showed that the accuracy in diagnosing central nervous system malformations of MRI was 93% compared to 63% of ultrasound.
Doctor Chau (female) supervises fetal MRI scans for pregnant women. Image: Tue Diem
Like Ms. Hien, 25 years old, living in Ba Ria – Vung Tau, 26 weeks pregnant, the doctor diagnosed congenital intestinal atrophy, severe prognosis, advised to terminate the pregnancy because of the possibility that the baby would be born prematurely or die in the womb. She went to Tam Anh General Hospital in Ho Chi Minh City for an examination. The doctor ordered an MRI to evaluate severe gastrointestinal defects.
“This case can be intervened after giving birth if the pregnancy is taken care of well,” said Dr. Chau. At 36 weeks of pregnancy, the doctor did an ultrasound and discovered that the fetus had amniotic fluid moving slowly in the intestines. Fetal intestinal motility was reduced, suspected intestinal volvulus, and the fetus’ abdomen was bulging. An emergency surgery was required to save the baby. Postnatal examination results of type 4 intestinal atrophy, which is the most severe level.
Doctor II Nguyen Do Trong, specializing in Pediatric Surgery, decided to operate on the baby 10 hours after birth to clear the blockage and avoid intestinal twisting or necrosis.
Ms. Hien gave birth to a healthy baby at Tam Anh General Hospital. Image: Tue Diem
Not as lucky as Ms. Hien, Ms. Minh, 34 years old, discovered mild ventricular dilatation on ultrasound, and an MRI scan recorded severe fetal malformations with a dire prognosis. MSc.BSc.CKI Tran Lam Khoa, Obstetrics and Gynecology Center, advised the couple to find the cause of the abnormal pregnancy. The fetus’ genetic test results were abnormal, but the parents’ genetic tests were normal.
Ms. Hien was 19 weeks pregnant for the second time. This situation repeated, with abnormal genetic results similar to the first pregnancy, the couple decided to terminate the second pregnancy. Doctor Lam Khoa advised her to perform IVF combined with embryo screening to have a chance of having a healthy baby. Currently, she is 20 weeks pregnant. Screening surveys and fetal imaging showed no abnormalities.
Another case is Ms. Ngan, pregnant at 29 weeks and 5 days, an MRI scan showed severe brain abnormalities. Later, the fetus was determined to have a central nervous system abnormality due to the L1CAM mutation, and she and her husband decided to terminate the pregnancy. She was advised on IVF to screen for healthy embryos to give birth.
A pregnant woman has a fetal MRI scan. Image: Tue Diem
At Tam Anh General Hospital in Ho Chi Minh City, every day about 3-4 pregnant women are prescribed a fetal MRI scan. Most of them have abnormalities on ultrasound, requiring the use of more advanced diagnostic techniques to investigate fetal abnormalities.
Doctor Lam Khoa assessed that MRI helps fetal medicine doctors accurately determine the condition, thereby providing more data for fetal prognosis, postpartum intervention for the baby, and standardization. have a safe birth.
According to the Ministry of Health, our country has about one million children born each year, of which 22,000-30,000 have birth defects. By 2023, Vietnam will have about 1.2 million disabled children aged 0-17, accounting for 3.1%.
According to Dr. Lam Khoa, birth defects are caused by many factors such as genetic abnormalities, exposure to toxic chemicals, old age, infections during pregnancy, and folic acid deficiency before and during pregnancy. Some risk factors for increased birth defects include smoking, alcohol abuse, medication use…
Doctors warn that not all birth defects can be prevented. Pregnant women should get screened during pregnancy and comply with regular prenatal checkups to increase their chances of having a healthy baby.