SONOGRAPHIC ASSESSMENT OF SYLVIAN FISSURES IN FETUS OF 3RD TRIMESTER AMONG HYPERTENSIVE AND NON-HYPERTENSIVE MOTHER

Abstract

Background: The Sylvian fissure, an early fetal brain landmark, separates major lobes and forms the Sylvian cistern housing the middle cerebral artery and superficial vein. The third trimester shows rapid cortical sulcation and operculization, enabling sonographic assessment of fissure depth and maturation. Maternal hypertensive disorders like preeclampsia cause placental insufficiency and hypoxia, potentially disrupting cortical folding. Prenatal ultrasound evaluation of the Sylvian fissure offers a non-invasive method to detect early neurodevelopmental vulnerability from maternal hypertension.

Objective: determine the correlation between maternal hypertension and fetal Sylvian fissure morphology in third-trimester fetuses using sonographic assessment.

Methodology: This descriptive analytical study evaluated Sylvian fissure morphology (depth, width, opercularization) in 35 third-trimester fetuses of hypertensive and normotensive mothers. Participants were recruited via convenience sampling at CMH Okara Cantt, underwent transabdominal ultrasound scans, and measurements were repeated thrice. Data were analyzed using SPSS, applying descriptive statistics and independent t-tests.

Results: Maternal preeclampsia significantly impacts fetal cortical development and perinatal outcomes. Hypertensive pregnancies create a pathological intrauterine environment with placental dysfunction, reduced perfusion, and fetal hypoxia, affecting cortical folding measured via the Sylvian fissure. Fetuses show reduced fissure depth and delayed operculization, while exposed neonates are at higher risk of low birth weight, IUGR, respiratory issues, and later cognitive or behavioral delays. Early SF sonography serves as a non-invasive marker of altered cortical maturation.

Conclusion: The study evaluated safety and effectiveness of ablation therapy for adenomyosis and uterine fibroids. 63% reported no post-procedure complications, confirming it as generally safe and effective. Common side effects were mild bleeding, pain, and infection, consistent with earlier studies. Ablation techniques including HIFU and RFA proved practical, minimally invasive, and uterus-preserving options for benign gynecologic disease.