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Poster Session 2

Category: Ultrasound/Imaging

Poster Session 2

(437) Routine use of fetal brain MRI following fetal intervention

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Asia Gandy, MD

Resident Physician
University of California, San Francisco
San Francisco, California, United States

Coauthor(s)

OG

Orit Glenn, MD

Professor
University of California, San Francisco
San Francisco, California, United States
VF

Vickie Feldstein, MD

Professor
University of California, San Francisco
San Francisco, California, United States
Nasim C. Sobhani, MD

Associate Professor
UCSF
UCSF/San Francisco, California, United States

Objective:
Fetal interventions may be associated with central nervous system (CNS) injuries. CNS injuries can be identified by obstetric ultrasound (US), with fetal brain MRI as an adjunct as needed. Whether fetal brain MRI should be routinely offered following fetal interventions remains an area of clinical equipoise. This study aimed to determine the incidence of CNS anomalies in a cohort that underwent both US and MRI as part of routine postprocedural care following fetal intervention.

Study Design:
Retrospective single-center cohort study of all pregnancies that underwent routine postprocedural fetal brain MRI following fetal intervention, from 2014-2016 and 2021-2024. Cases from 2017-2020 were excluded due to a policy change in recommending postprocedural fetal brain MRI. The primary outcome was incidence of new CNS anomalies identified by any imaging modality. Secondary outcomes included incidence of anomalies identified by both US and MRI and by MRI alone.

Results:
A cohort of 73 patients were included, of which 93% were monochorionic-diamniotic twin pregnancies. The most common procedures were laser ablation for TTTS (59%) and selective reduction (36%). Median gestational age at time of procedure, post-procedure US, and post-procedure MRI was 19.9, 22.3, and 22.6 weeks, respectively. Of the 73 patients, 12% (9) were found to have a new CNS anomaly (Figure). Of those, 33% (3) were identified by US imaging prior to MRI, whereas the remaining 66% (6) were identified only at the time of fetal brain MRI (Table).

Conclusion:
In this single center cohort, 12% of pregnancies were found to have new CNS anomalies following fetal intervention. Notably, 66% of these were identified only by fetal brain MRI, suggesting that US alone as a routine screening tool following fetal interventions could miss CNS anomalies. Consideration should be given to routine use of fetal brain MRI in this population. More research is needed to determine the long-term neonatal consequences and clinical significance of the postprocedural CNS anomalies detected by MRI only.