TY - CHAP M1 - Book, Section TI - Preface to the Fourth Edition A1 - Malinger, Gustavo A1 - Monteagudo, Ana A1 - Pilu, Gianluigi A1 - Paladini, Dario A1 - Timor-Tritsch, Ilan E. PY - 2023 T2 - Timor's Ultrasonography of the Prenatal Brain, 4e AB - Turning the pages of this fourth edition of Ultrasonography of the Fetal Brain, several thoughts come to mind. The first and most obvious one is that there have been impressive developments in the field of fetal neurosonography in recent years. The second, and to us the most intriguing one, is how the scope of the research in this area has changed with time. In the beginning, the ambition of the fetal sonologists was a simple one: to recognize neural tube defects. Later, it became clear that more subtle intracranial anomalies could be identified. At that point, it became clear that little was known about the prognosis of many of these conditions, and that counseling couples was a very difficult, sometimes even impossible, task. The intracranial anomalies that were detected could be associated with significant neurologic compromise; however, at the same time they could be completely asymptomatic. This standoff prompted a wave of studies to evaluate the postnatal development of infants diagnosed with abnormal cerebral anatomy in utero, as well as to identify the sonographic features that could make a difference in their outcome. The brain is in many ways an unexplored organ, and sonologists understood that not only was long-term follow-up necessary to obtain meaningful data, but also that intellectual function cannot be measured as easily as blood pressure or cardiac output. However, the wealth of data that continues to be generated by these studies is providing a significant contribution not only to prenatal diagnosis but to the entire field of fetal and pediatric neurology. In many ways, this bootstrapping process (recognizing anomalies while delineating their clinical implications) was at the forefront of a new type "backward medicine," that, for good or bad, is here to stay, as the side product of the widespread use of diagnostic imaging: predicting the consequences of abnormally shaped organs in asymptomatic individuals the complete opposite of traditional medicine. SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/10/08 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1194694516 ER -