[[Intrahepatic arteriovenous fistula. Prenatal diagnosis, physiopathological study and neonatal management]l].

A case of arteriovenous fistula of the liver diagnosed at 30 weeks of gestation is reported. The etiologies of an hypoechogenic structure in the fetal liver are discussed showing the contribution of pulsed wave Doppler and color Doppler to the diagnosis. The clinical evolution towards heart failure led us to examine the pathophysiology of such a lesion.

[Operations guided by echography].

The considerable development, during the last few years, of the antenatal diagnosis of congenital abnormalities is due to progress in cytogenetics but also to rapid improvements in obstetrical ultrasonography. With high-resolution ultrasound scanners, various interventions performed increasingly early during pregnancy can be guided with an ever decreasing risk. Thus, genetic diseases can now be detected at a very early stage by chorion biopsy combined with genetic engineering, and direct foetal blood sampling with a needle guided by ultrasound increases our knowledge of foetal physiology and provides an access to antenatal pathology.

Prenatal management of 746 pregnancies at risk for congenital toxoplasmosis.

When infection with Toxoplasma gondii occurs during pregnancy, there is a risk that the parasite will cause severe congenital toxoplasmosis. We developed a method of diagnosing and treating congenital toxoplasmosis in utero. Diagnosis was based on the identification of maternal acute infection, followed by culture of fetal blood and amniotic fluid, testing of fetal blood for toxoplasma-specific IgM and nonspecific measures of infection, and ultrasound examination of the fetal brain.

Fetal blood sampling in twin pregnancies. Prenatal diagnosis and management of 19 cases.

Twin pregnancies pose particular problems in both prenatal diagnosis and obstetric management. We present 19 twin pregnancies that underwent fetal blood sampling (FBS). The indications were mostly similar to those for singleton pregnancies, with both fetuses being sampled.