Does whole-body in-utero MRI in those with suspected fetal abnormalities improve antenatal care? A single-centre retrospective cohort study

Objective: To determine whether full body in-utero MRI (iuMRI) rather than targeted imaging adds useful clinical information when a fetal anomaly is suspected in the brain or the body.

Design: Single-centre retrospective cohort study, from October 2011 to May 2022.

Setting: Regional fetal MRI service in Sheffield, UK.

Patients: All pregnant people undergoing iuMRI.

Interventions: iuMRI of the brain and body was reviewed by a fetal radiologist, and the results discussed by a multidisciplinary team.

Main outcome measures: Additional abnormalities detected on iuMRI outside of the initial area of interest on ultrasound.

Results: 1876 participants: 916 participants had a fetus with brain anomalies only on ultrasound, of which 12 (1.3%) had additional body abnormalities on iuMRI. 960 participants had body anomalies only on ultrasound, of whom 8 (0.8%) had an additional brain abnormality. The additional findings from 12 cases (0.6% of whole cohort) added useful clinical information to guide care or counselling.

Conclusion: If brain or body anomalies are found on ultrasound in the fetus, whole-body iuMRI reveals additional abnormalities in a small number of cases. However, these may provide important information that changes counselling or care. Further research is required to determine how significant this impact is for clinicians and families, whether normal findings reassure families, how long whole-body iuMRI adds to the MRI acquisition time and the health economics implications.