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Fetal, obstetrical ultrasound diagnosis

P Rozenberg
Macrosomic fetuses are at increased risk of obstetric complications, and notably shoulder dystocia, responsible for a severe neonatal morbidity. In case of fetal macrosomia, three options are: (i) the elective cesarean delivery, but this is recommended only when the estimated fetal weight is≥4500g for diabetic women and 5000g for non-diabetic women; (ii) the expectative management, but children with birth weight≥4500 had significantly increased risk of perinatal mortality, neonatal asphyxia, trauma, and cesarean delivery; (iii) the induction of labor which, reducing the possibility of fetal growth, reduce the risk of cesarean delivery for cephalopelvic disproportion and shoulder dystocia...
October 19, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Annah Lane, Ling Lee, Donna Traves, Andreas Lee
INTRODUCTION: The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature...
October 21, 2016: Journal of Medical Imaging and Radiation Oncology
Bryn Putbrese, Anne Kennedy
Ventriculomegaly (VM) is a nonspecific finding on fetal imaging. Identification of the specific etiology is important as it affects prognosis and may even change the course of current or future pregnancies. In this review we will focus on the application of fetal MRI to demonstrate intracranial hemorrhage (ICH) and ischemic brain injury as opposed to other causes of VM. MRI is able to identify the specific etiology of ventriculomegaly with much more sensitivity and specificity than ultrasound and should be considered whenever VM is identified on obstetric ultrasound...
October 13, 2016: British Journal of Radiology
Priyanka Jha, Viktoriya Paroder, Winnie Mar, Jeanne M Horowtiz, Liina Poder
Placental masses are uncommonly identified at the time of obstetric ultrasound evaluation. Understanding the pathologies presenting as placental masses is key for providing a differential diagnosis and guiding subsequent management, which may include additional imaging with magnetic resonance (MR) imaging. Potential benign entities include chorioangiomas and teratomas. Larger chorioangiomas can cause fetal cardiovascular issues from volume overload. Placental mesenchymal dysplasia has an association with fetal anomalies and detailed fetal evaluation should be performed when it is suspected...
September 30, 2016: Abdominal Radiology
C Scala, S McDonnell, F Murphy, U Leone Roberti Maggiore, A Khalil, A Bhide, B Thilaganthan, A T Papageorghiou
OBJECTIVES: To establish the diagnostic accuracy of obstetric ultrasound at a tertiary fetal medicine centre in the prenatal detection of unilateral and bilateral MCDK in fetuses where this condition was suspected; and to undertake a systematic review of the literature on this topic. METHODS: Retrospective observational study of all cases with an antenatal diagnosis of either unilateral or bilateral MCDK referred to a regional tertiary fetal medicine unit between 1997 and 2015...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
Hassan M Harirah, J Michael Smith, C Luke Dixon, Gary D V Hankins
Advanced abdominal pregnancy is an extremely rare condition that poses diagnostic and management challenges. A high index of suspicion and careful assessment of the patient's symptoms, supplemented with obstetric ultrasound, and magnetic resonance imaging, are crucial for timely diagnosis and management to prevent life-threatening complications. The presence of periviable fetuses in advanced abdominal pregnancies increases the challenge to achieve a balance between maternal and fetal benefits and risks. Early diagnosis and management decisions via a multidisciplinary approach and planned delivery are of paramount importance to minimize complications and achieve favorable maternal and fetal outcomes...
July 2016: American Journal of Perinatology Reports
Nisrine Mamouni, Nabil Ghazal, Sanaa Erraghay, Chahrazed Bouchikhi, Abdelaziz Banani
The occurrence of rudimentary horn pregnancy is an extremely rare and potentially serious obstetric entity, threatening maternal and fetal outcome. The authors report five cases of rudimentary horn pregnancy, the difficulties in making a proper diagnosis and the therapeutic management of this pathological entity, stressing the importance of transvaginal ultrasound, of pelvic MRI and laparoscopy in the early diagnosis of this type of uterine malformation.
2016: Pan African Medical Journal
Christina A Herrera, Robert M Silver
Perinatal asphyxia is a general term referring to neonatal encephalopathy related to events during birth. Asphyxia refers to a deprivation of oxygen for a duration sufficient to cause neurologic injury. Most cases of perinatal asphyxia are not necessarily caused by intrapartum events but rather associated with underlying chronic maternal or fetal conditions. Of intrapartum causes, obstetric emergencies are the most common and are not always preventable. Screening high-risk pregnancies with ultrasound, Doppler velocimetry, and antenatal testing can aid in identifying fetuses at risk...
September 2016: Clinics in Perinatology
R E Bohîlțea, M M Cîrstoiu, A I Ciuvica, O Munteanu, O Bodean, D Voicu, C A Ionescu
A velamentous umbilical cord is characterized by membranous umbilical vessels at the placental insertion site that are prone to compression and rupture, especially when they are located in the membranes covering the cervical os (vasa praevia). The velamentous insertion of the umbilical cord, with a reported incidence of 1% in singleton pregnancies and 15% in monochorionic twin gestations, has been associated with obstetric complications: fetal growth restriction, prematurity, congenital anomalies, low Apgar scores, fetal bleeding with acute fetal distress and placental retention...
April 2016: Journal of Medicine and Life
Xu Li, Xue-Lei Li, Kefei Hu, Chuangao Yin
BACKGROUND: Here we report our preliminary experience of using fetal cardiovascular magnetic resonance (CMR) imaging, particularly with transverse views at the level of the aortic arch, in the diagnosis of aortic arch anomalies. MATERIALS AND METHODS: Between January 2013 and December 2015, routine prenatal obstetric ultrasound (US), echocardiography (Echo) and 1.5 T CMR were performed on approximately 600 pregnant women. CMR included balanced fast field echo and single-shot fast spin echo sequences...
July 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
Alexandra Drought, Ruwan Wimalasundera, Susan Holder
The finding of bilateral congenital cataracts in the fetus is rare. We report bilateral congenital cataracts detected during the routine second trimester anomaly scan, which subsequently were found to be associated with other congenital anomalies and the parents opted for a termination of pregnancy. At post-mortem, Muscle-Eye Brain disease or Walker-Warburg Syndrome was considered likely, which are autosomal recessive congenital muscular dystrophy disorders associated with cerebral, cerebellar, muscle and eye anomalies...
August 2015: Ultrasound: Journal of the British Medical Ultrasound Society
L I Belmonte-Andújar, A M Fuentes-Rozalén, R M Soler-Garcia
BACKGROUND: Vasa praevia is a rare pregnancy complication with a high fetal mortality when not diagnosed in the prenatal period. CLINICAL CASES: two cases of vasa praevia diagnosed during the second trimester ultrasound cervical measurement. CONCLUSIONS: We propose carry out further investigation about cost effectiveness of double vaginal screening (cervical length measurement and vasa praevia) during the second trimester morphology ultrasound...
March 2016: Ginecología y Obstetricia de México
Saulo Molina-Giraldo, Luis Alfonso-Ospina, Carolina Parra-Meza, Eder Ariel Lancheros-García, José Luis Rojas-Arias, Edgar Acuña-Osorio
OBJECTIVE: To establish the prevalence of congenital malformations diagnosed in Maternal-Fetal Medicine Unit of Hospital de San José, Bogotá-Colombia and comparing them to national and international reports. MATERIALS AND METHODS: Retrospective, descriptive observational where the quantification of all malformed fetuses diagnosed in Maternal-Fetal Medicine Unit from June 2010 to June 2013 was performed. RESULTS: 236 malformed fetuses, a total of 11,914 births, for a prevalence of 1...
November 2015: Ginecología y Obstetricia de México
Lasya Gaur, Lauren Talemal, Dorothy Bulas, Mary T Donofrio
OBJECTIVE: Abnormal cardiac axis and/or malposition prompts evaluation of congenital heart disease; however, etiology may be difficult to clarify using obstetrical ultrasound or fetal echocardiography (echo) alone. We aimed to use fetal magnetic resonance imaging (MRI) as a complementary tool to identify causes of cardiac malposition. METHODS: Review of fetuses diagnosed with cardiac malposition by fetal ultrasound and echo was performed. Etiology was classified as either because of heterotaxy syndrome or extracardiac masses...
August 2016: Prenatal Diagnosis
Assaad Kesrouani, Alain Daher, Ali Maoula, Elie Attieh, Sami Richa
OBJECTIVE: Evaluate the outcome of prenatally diagnosed nuchal cord. METHODS: A retrospective study on all cases of prenatally diagnosed nuchal cord. Study end points were gestational age at delivery, intrapartum fetal heart rate (FHR) abnormalities, mode of delivery, intrauterine fetal growth retardation (IUGR), intrauterine fetal demise (IUFD), and the rate of labor induction. RESULTS: This study included 44 cases; 86% were diagnosed at second trimester scan, confirmed by Color Doppler and 3D ultrasound...
April 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
J Dukanac Stamenkovic, M Steric, L Srbinovic, T Janjic, S Vrzic Petronijevic, M Petronijevic, A Cetkovic
PURPOSE: The objectives of this study were as follows: to present the course and outcome of pregnancies complicated with fetal ventriculomegaly, determine the association between prenatal ultrasound diagnoses and definitive postnatal diagnosis or diagnoses after autopsy and additional analysis, and to monitor the psychomotor development of children born with ventriculomegaly. MATERIALS AND METHODS: The survey was designed as retrospective study and included 62 pregnant women who were attending a regular ultrasound examinations at the Department of Gynecology and Obstetrics, Clinical Center of Serbia, or patients who were referred from other institutions in Serbia...
2016: Clinical and Experimental Obstetrics & Gynecology
Catherine A Bigelow, Christina M Cinelli, Sarah E Little, Carol B Benson, Mary C Frates, Louise E Wilkins-Haug
OBJECTIVES: To report our contemporary experience with PUBS, including indications and complications, stratified by the presence of hydrops fetalis. STUDY DESIGN: All PUBS performed from 1988 to 2013 at a single tertiary care center were identified using a comprehensive ultrasound database. We recorded patient demographics, relevant obstetric, fetal and neonatal data, indication for and success of PUBS and any complications. Data were analyzed using SAS, version 9...
May 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
L Pasquini, V Seravalli, G Sisti, C Battaglini, F Nepi, R Pelagalli, M Di Tommaso
OBJECTIVE: The aim of this study was to evaluate the rate of women with polyhydramnios who eventually screened positive to infectious disease by serum screening testing for TORCH and parvovirus B19. METHODS: This is a retrospective observational study on singleton pregnancies with a diagnosis of polyhydramnios and who had serum screening for TORCH and parvovirus B19. Patients were followed with serial ultrasounds between 2006 and 2013. Maternal characteristics, medical and obstetric history were reviewed...
March 2016: Prenatal Diagnosis
Etty Daniel-Spiegel, Micha Mandel, Daniel Nevo, Avraham Ben-Chetrit, Ori Shen, Eliezer Shalev, Simcha Yagel
BACKGROUND: Selection of appropriate reference charts for fetal biometry is mandatory to ensure an accurate diagnosis. Most hospitals and clinics in Israel use growth curves from the United States. Charts developed in different populations do not perform well in the Israeli population. OBJECTIVES: To construct new reference charts for fetal biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), using a large sample of fetuses examined at 14-42 weeks gestational age in a medical center and a community ultrasound unit located in two different regions of Israel...
January 2016: Israel Medical Association Journal: IMAJ
Jeffrey N James, Daniel W Schlieder
A multidisciplinary team is the standard of care and the cornerstone of management of cleft patients. With readily improving advanced diagnostic modalities, early prenatal diagnosis of cleft lip and palate increasingly becomes a topic of importance for both the team caring for and families of cleft patients. Maternal-fetal medicine is a fellowship subspecialty of obstetrics that can offer high-quality care and coordination to the cleft team. Both 3-D and 4-D sonography lead to early prenatal diagnosis of cleft patients; however, differences in training result in variations in its diagnostic accuracy...
May 2016: Oral and Maxillofacial Surgery Clinics of North America
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