Ultrasound Obstet Gynecol
July 1995
Background: Abnormalities of the upper and lower extremities, such as club feet, rocker-bottom feet, and abnormal hand posturing, are frequently detected prenatally in trisomy 18 fetuses. Aplasia of the radius, usually associated with the absence or hypoplasia of the first metacarpal and thumb, is the most prevalent reduction malformation in trisomy 18 infants. Because this anomaly is easily missed during prenatal ultrasonography, the role of prenatal detection of this particular preaxial upper limb reduction has not been emphasized.
View Article and Find Full Text PDFThe fetal gall bladder can now be easily identified during the second and third trimesters using high-resolution ultrasonography. In this report we present eight fetuses with an enlarged gall bladder detected on prenatal ultrasonography at a mean gestational age of 24.6 weeks (range 19-31 weeks).
View Article and Find Full Text PDFUltrasound Obstet Gynecol
February 1995
We examined retrospectively the use of ultrasonography in 18 cases in which a true knot of the umbilical cord was found at delivery. All women had a normal second-trimester scan in which no cord abnormality was detected. Thirteen (72%) also had third-trimester color Doppler ultrasonography, at which time the cord anomaly was again missed.
View Article and Find Full Text PDFCurrent referral practice for ultrasonically detected fetal abnormalities contributes to parental anxiety, inconvenience to patients, diagnostic inaccuracy, and general service inefficiency. To determine whether telemedicine would reduce these disadvantages, we established a 30-channel ISDN link between a district general hospital on an island and a subspecialty referral centre approximately 120 km away on mainland Britain. Live ultrasound images of the fetus were transmitted in realtime from a commercial scanner in the hospital using a total data transfer rate of 2 Mbit/s.
View Article and Find Full Text PDFIncidental fetal yawning movements can rarely be observed during real-time ultrasonographic examination. In this report we document repetitive fetal yawning movements in a 27-week fetus over a 7-min period. Each episode lasted for 4-6 s, and the intervals between them varied from 21 to 195 s.
View Article and Find Full Text PDFThe association between second-trimester hyperechogenic bowel and Down syndrome has been well established in the literature. In this report we present a case of Down syndrome in which this finding was only detected during the third-trimester scan, after normal bowel echogenicity was documented in the second trimester. This report suggests that hyperechogenic bowel could be a late manifestation of Down syndrome.
View Article and Find Full Text PDFExencephaly was diagnosed at 17 weeks in a 27-year-old primigravida with abnormalities of the hands and a family history suggestive of autosomal dominant brachydactyly and clinodactyly. In this family there was also a history of 'anencephaly'. To our knowledge, this is the first report on the association of exencephaly and autosomal dominant brachydactyly.
View Article and Find Full Text PDFObjective: To audit routine measurement of alpha-fetoprotein (AFP) and acetylcholinesterase in amniotic fluid (AF) samples obtained at second-trimester amniocentesis.
Methods: We reviewed retrospectively 1737 consecutive AF specimens obtained for cytogenetic evaluation over a 4-year period and routinely assayed for AFP and acetylcholinesterase. In all instances, high-resolution ultrasonography was performed before amniocentesis.
Prenat Diagn
December 1994
Hypospadias is one of the most prominent and characteristic midline defects in male infants with the Wolf-Hirschhorn (4p-) syndrome. In this report we present a case in which hypospadias was identified prenatally at 29 weeks' gestation in association with intrauterine growth retardation. Cytogenetic evaluation after birth confirmed a 46,XY,del(4)(p14) karyotype.
View Article and Find Full Text PDFJ Ultrasound Med
December 1994
Eight instances of homogeneous, well-defined echoes within the fetal stomach were identified on routine second trimester detailed scan over a 7 month period, a prevalence of 1 in 287 or 0.35%. This finding was significantly more frequent in women who had cytogenetic amniocentesis than in those who had not had the procedure (4 in 266 [1.
View Article and Find Full Text PDFAm J Obstet Gynecol
August 1994
Objective: The aim of this study was to investigate pelvic and femoral arterial flow velocity waveforms in fetuses with a single umbilical artery.
Study Design: Seven fetuses with single umbilical artery and no other ultrasonographically detected anomalies were studied with color Doppler ultrasonography at a median gestational age of 24 weeks (range 18 to 34 weeks). Flow velocity waveforms from the relevant vessels were obtained as follows: (1) umbilical artery from a free loop of cord, (2) common iliac artery from both sides just below the aortic bifurcation, (3) internal iliac artery and intraabdominal portion of the umbilical artery from the vessel visualized alongside the fetal bladder, and (4) femoral artery on both sides from the upper third of the fetal thigh.
The purpose of this study was to investigate whether the fetus mounts a hormonal stress response to a potentially painful procedure, intrauterine needling. Cortisol and beta-endorphin concentrations in fetal plasma obtained during uncomplicated fetal blood sampling or intrauterine transfusions by needling the fetal intra-abdominal portion of the umbilical vein (intrahepatic vein) were compared to hormone concentrations in fetal plasma obtained by the conventional technique of needling the placental cord insertion, which is not innervated. Cortisol and beta-endorphin concentrations did not increase within 10 minutes of fetal abdominal needling (n = 15).
View Article and Find Full Text PDFObjective: Our purpose was to study the effect of operator transducer pressure on amniotic fluid index and single deepest pool measurements and their intraobserver and interobserver variability.
Study Design: Forty subjects in the third trimester with intact membranes were studied by two observers at three predetermined operator pressures. Pressure was measured by interfacing a flexible water-filled reservoir connected to a manometer between the maternal abdomen and the ultrasonography transducer.
Objective: To test the hypothesis that increased echogenicity of the fetal bowel at second-trimester scans results from intra-amniotic bleeding.
Methods: We studied 726 patients undergoing second-trimester amniocentesis for advanced maternal age. Three groups were identified according to the color of the amniotic fluid (AF) obtained: clear fluid, blood-stained fluid, and dark brown fluid.
Sirenomelus is an invariably lethal congenital anomaly characterized by complete or nearly complete fusion of the lower extremities that occurs in 1 of 60,000 births. In about 50% of cases this condition cannot be diagnosed prenatally because of the associated oligohydramnios that precludes a detailed examination of the fetus. We present a case of sirenomelus in which prenatal diagnosis was aided by color Doppler ultrasonography; visualization of the vitelline artery as a single, large intraabdominal vessel that did not branch in the fetal pelvis but rather coursed ventrally into the umbilical cord proved to be diagnostic of this rare condition.
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