[Agenesis of the corpus callosum. An example of prognosis uncertainty in fetal medicine].

OBJECTIVE

For an increasing number of fetal pathologies, means of diagnosis have progressed faster than knowledge of the prognosis. Decisions are extremely difficult for the medical staff and the parents each time that outcome is uncertain. Agenesis of the corpus callosum, whose diagnosis may be certain through ultrasonography and MRI illustrates this situation well.

METHODS

A historical multicentric study enabled us to analyze 37 cases of agenesis of the corpus callosum with a prenatal diagnosis and 10 cases with a post-natal one.

RESULTS

Among the 37 prenatal diagnoses, we found 28 cases of medical abortions according to the French law and 9 newborns. Among the 9 newborns, we observed one neonatal death related to an acute fetal distress and 3 post-natal deaths between 1 and 3 months. Among the 10 cases diagnosed after birth, one died, 7 are in good health with a follow-up from 7 months to 6 years and 2 have neurological disturbances.

CONCLUSION

Therefore, it seems essential to deepen knowledge of the prognosis and the evolutivity of this affliction in order to give the parents more precise information. However, knowledge of the prognosis is difficult because of the large number of abortions performed for medical reasons. Only a multicentric study, with a long-term pediatric follow-up, will enable us to better understand the prognosis of corpus callosum agenesis.