Possibilities for early diagnosis of fetal central nervous system lesions in the antenatal period (review)

Background: Fetal brain damage during pregnancy is a major cause of neonatal death and disability, as well as infantile cerebral palsy. Infants with cerebral palsy experience motor impairments of varying severity that appear to be secondary to brain lesions or abnormalities that occur during the perinatal period. The aim of the study: To analyse modern methods for early diagnosis of fetal central nervous system lesions in the antenatal period. Materials and methods: A search in information databases using the given keywords: “placental insufficiency”, “magnetic resonance imaging”, “fetal neurosonography”, “ultrasound Dopplerography”, “fetal brain lesions” has revealed 1473 articles devoted to the problems of diagnosing fetal central nervous system lesions in the antenatal period period. After excluding duplicate publications (852) and publications more than 10 years old (574), 47 literature sources were analysed. The study used the following data bases: PubMed, PubMed Central, Scopus, MEDLINE, ScienceDirect, Cochrane Library, eLibrary for the period from 2014 to November 2023. Results: Magnetic resonance imaging (MRI) can determine the presence of congenital abnormalities of CNS, white matter abnormalities, and the amount of deoxyhemoglobin in the nervous tissue in the fetus; and also identify placental disorders. Neurosonography is a prenatal diagnostic method that visualizes intracerebral hemorrhages, the structure of the cerebral cortex, Sylvian fissure and corpus callosum. The consistent use of these diagnostic methods in patients at risk contributes to the personalization of management and delivery tactics, which in the future will reduce the incidence of adverse perinatal outcomes and losses. Conclusion: MRI not only makes it possible to assess the fetal central nervous system, but also allows the placenta to be assessed. This method will allow us to take a fresh look at the problem of chronic placental insufficiency and more qualitatively assess the degree of influence of placental disorders on the fetus. Neurosonography, in turn, is a more accessible method for diagnosing the pathological state of the fetal central nervous system, which also has high sensitivity in the prenatal detection of ischemic-hypoxic brain damage.