What is done if a lemon sign is positive?

What is done if a lemon sign is positive?

• A. Follow up with ultrasound to spine for further visualization
• B. Immediate cesarean birth
• C. Start fetal chemotherapy
• D. Do nothing and await birth

Answer: (A)

A positive lemon sign signals the possibility of an open neural tube defect, most commonly spina bifida with potential hindbrain involvement. The best next step is to perform a targeted ultrasound of the fetal spine and posterior fossa to confirm the defect, assess its extent, and look for associated anomalies. This confirmation and detailed imaging guide counseling, prognosis, and planning for care at a specialized center, rather than taking immediate action such as cesarean delivery or any treatment. Immediate cesarean birth, fetal chemotherapy, or doing nothing would not appropriately address the need to define the anatomy and plan management based on solid imaging findings.

A positive lemon sign signals the possibility of an open neural tube defect, most commonly spina bifida with potential hindbrain involvement. The best next step is to perform a targeted ultrasound of the fetal spine and posterior fossa to confirm the defect, assess its extent, and look for associated anomalies. This confirmation and detailed imaging guide counseling, prognosis, and planning for care at a specialized center, rather than taking immediate action such as cesarean delivery or any treatment. Immediate cesarean birth, fetal chemotherapy, or doing nothing would not appropriately address the need to define the anatomy and plan management based on solid imaging findings.