Can ultrasonography replace amniocentesis in fetal gender determination during the early second trimester?

Fetal gender was prospectively determined by ultrasonography in 115 patients with singleton pregnancies between 16 and 20 weeks of gestation. Gender determination was performed as a part of the sonographic examination preceding genetic amniocentesis, and the results were compared to the amniotic fluid fetal karyotype results. Our rate of visualization of the fetal external genitalia was 83.

Screening for gestational diabetes: one-hour carbohydrate tolerance test performed by a virtually tasteless polymer of glucose.

Although the 1-hour 50 gm blood glucose screening test is an effective way of detecting diabetes in pregnancy, the taste of available glucose drinks often creates gastrointestinal symptoms and leads to refusal of the patient to be tested. The efficacy of a virtually tasteless glucose polymer in testing carbohydrate tolerance in pregnancy was determined. Sixty-one pregnant patients undergoing screening for gestational diabetes underwent a 1-hour carbohydrate tolerance test of both glucose and a glucose polymer within 3 days of each other.

Criteria for the prenatal diagnosis of holoprosencephaly.

Holoprosencephaly is a congenital anomaly of the central nervous system whose prenatal sonographic appearance may to similar to that of ventriculomegaly. A clear differential diagnosis is extremely important because the two conditions have different prognoses and therefore require different obstetric management. Eight cases of prenatally recognized holoprosencephaly are analyzed and criteria for a specific diagnosis proposed.

Intrapartum fetal activity.

Fetal activity throughout pregnancy has been thoroughly studied. Relatively little informations regarding intrapartum fetal activity is available. Richardson et al.

Intrapartum fetal weight estimation: a comparison of three formulae.

To determine the relative accuracy of fetal weight estimation using the biparietal diameter (BPD), the abdominal circumference (AC), and the femur length (FL) in three formulae (BPD/AC, FL/AC, and BPD/AC/FL), 63 patients in labor were examined. All patients delivered within 24 hours of ultrasound examination. A good correlation was found between the estimated fetal weight and the actual birth weight, using the three formulae: BPD/AC (r = 0.

Antenatal diagnosis and obstetric management of Dandy-Walker syndrome.

Real-time ultrasound equipment has the potential for investigating the fetal neural axis and allows the diagnosis of many anomalies arising from this area. Five cases of Dandy-Walker syndrome, one of the major causes of congenital hydrocephalus, were diagnosed antenatally. In all cases ultrasound allowed specific recognition of the defect in the cerebellar vermis.

Facial anatomy of the fetus.

Real-time ultrasonography was used in this study to demonstrate details of the anatomy of the face and neck of the fetus. Details such as the ocular globe, vitreous body, lens, anterior chamber, rectus muscles, optic nerve and disc, and the ophthalmic artery are visible at the level of the eye. The helix, scaphoid fossa, triangular fossa, concha, antihelix, antitragus, intertragic incisure, and lobule can be seen at the level of the ear.

Congenital absence of the umbilical cord resulting from maldevelopment of embryonic body folding.

We report a case of extreme maldevelopment of embryonic body folding that resulted in incomplete fusion of the amnion to the chorion and failure to form an umbilical cord. Massive intra-abdominal and intrathoracic herniation led to rapid neonatal death. The accurate ultrasonic characterization of the defect enabled prudent perinatal management.

Rise in maternal serum alpha-fetoprotein concentration after chorionic villus sampling and the possibility of isoimmunization.

Maternal serum alpha-fetoprotein concentrations were determined by radioimmunoassay in 72 patients immediately before and after chorionic villus sampling for prenatal diagnosis. Fifty percent showed a rise of greater than or equal to 5 ng/ml. Assuming such rises represent fetal blood crossing the intervillous space, in 14% of the cases greater than or equal to 60 microliters of fetal blood was transferred at the time of chorionic villus sampling.

Perineal scanning.

Although various techniques have been described to aid in the ultrasound diagnosis of placenta previa and incompetent cervix, these maneuvers depend on the precise identification of the internal cervical os, a feat which is notoriously difficult to accomplish consistently. In an attempt to get a closer view of the cervix we tried another approach. This simple technique of perineal scanning has the potential to help considerably with these problems.

Arachidonic acid prevents hyperglycemia-associated yolk sac damage and embryopathy.

Light microscopic, electron microscopic, and morphometric studies were performed on rat conceptuses cultured between day 10 and day 12 in normal, hyperglycemic, arachidonic acid-supplemented normal, and arachidonic acid-supplemented hyperglycemic rat serum. The results were compared with those of 12-day-old conceptuses grown in utero. No major differences were observed between in vivo and in vitro control conceptuses.

The value of serial human chorionic gonadotropin testing as a diagnostic tool in ectopic pregnancy.

This study examines the sensitivity of serial human chorionic gonadotropin determinations in the detection of ectopic pregnancy for patients who present with human chorionic gonadotropin titers less than 6500 mIU/ml. A log human chorionic gonadotropin time curve was used to calculate the slope of change. A slope below 0.

Ultrasound cystourethrography by perineal scanning for the assessment of female stress urinary incontinence.

Perineal scanning using linear array ultrasound was used as an alternative to radiologic cystourethrography in the investigation of female urinary incontinence. The technique provides similar information to that obtained by fluoroscopy without exposing the patient and the physician to radiation. The bladder neck and urethra as well as the urodynamic catheter are readily visualized.

Prenatal diagnosis of craniofacial malformations with ultrasonography.

Although the utility of ultrasound in the prenatal diagnosis of many congenital anomalies is well established, its accuracy in detecting craniofacial malformations has not been examined in a large series. Sonographic examinations of 223 patients at risk for fetuses with craniofacial malformations were performed between 18 and 40 weeks. The risk factors included a familial history of craniofacial malformations, extrafacial anomalies diagnosed on ultrasound, fetal chromosomal aberrations, and maternal drug intake.

The fetal subarachnoid cisterns: an ultrasound study with report of a case of congenital communicating hydrocephalus.

The intracranial anatomy of 351 normal fetuses, ranging from 15 to 42 weeks' gestational age, was investigated sonographically in an attempt to define the normal sonographic anatomy of the subarachnoid spaces during intrauterine development. The triangular velum, vein of Galen, ambient, interpeduncular, chiasmatic, Sylvian, and supracerebellar cisterns and the cisterna magna were easily recognized in the vast majority of cases as fluid-filled spaces following the contour of the brain. A large fluid layer, overlying the cerebral convexities, was seen in early gestation and subsequently disappeared.

Diabetic embryopathy: pathogenesis, prenatal diagnosis and prevention.

In spite of the overall improvement in the management of diabetic pregnancies, congenital anomalies among infants of diabetic mothers still remain two to three times higher than in the nondiabetic population. Approximately 40 per cent of all perinatal deaths among diabetic offspring are due to congenital malformations. This article reviews the subject and discusses current views on pathogenesis, based on human and experimental work, describes methods available for prenatal diagnosis, and suggests an approach to the possible prevention of these malformations.

Intrathecal morphine analgesia for vaginal delivery in a woman with a single ventricle. A case report.

In a pregnant woman with a single cardiac ventricle, the coexisting cardiac anomalies provided a means of compensation. For vaginal delivery, intrathecal morphine was used for analgesia.

Use of parenteral antibiotic therapy to eradicate bacterial colonization of amniotic fluid in premature rupture of membranes.

The successful eradication of bacterial colonization of the amniotic fluid with parenteral maternal antibiotic therapy in a preterm gestation with premature rupture of membranes is reported. Amniotic fluid, obtained by amniocentesis, of a pregnancy complicated by premature rupture of membranes at 29 weeks was found to have three different bacterial species (Bacteroides bivius, Veillonella parvula, and Peptococcus). Because of prematurity and clinical quiescence, parenteral antibiotics were administered to the mother.

The prenatal diagnosis of Robin anomalad.

The Robin anomalad was diagnosed by the sonographic detection of polyhydramnios and fetal micrognathia in a patient at risk because of a previously affected child. Ultrasound in the second trimester failed to demonstrate any facial anomaly, but mandibular hypoplasia was clearly documented in the third trimester. The antenatal diagnosis allowed immediate neonatal assistance to prevent glossoptosis-induced respiratory failure.