RESUMEN
OBJECTIVE: To detect structural changes in the brain in fetuses with agenesis of the corpus callosum (ACC) and holoprosencephaly (HPE) in the first trimester. METHODS: The ultrasound data were analyzed retrospectively in 620 normal singleton fetuses between 11 and 13(+6) gestational weeks, 5 fetuses diagnosed to have ACC, and 13 fetuses with HPE. The midbrain diameter (MD) and falx diameter (FD) were measured and their ratio (MD/FD) was calculated for comparative analysis. RESULTS: No significant difference was found in the MD, FD, and MD/FD ratio between fetuses with ACC and HPE (P>0.05). Compared to the normal fetuses, all the fetuses with ACC and HPE showed significantly increased mean MD and MD/FD ratio (P<0.05); 4 (80%) fetuses with ACC and 11 (84.6%) with HPE had a reduced FD. All the fetuses with ACC and HPE had MD/FD ratios greater than 1, which were below 1 in all the normal fetuses. CONCLUSION: In the first trimester, fetuses with ACC and HPE have measurable abnormalities in the midbrain and falx area of the brain, and these changes, represented by abnormal midsagittal MD, FD and their ratio, can be of value in detecting ACC or HPE in fetuses in the first trimester.
Asunto(s)
Agenesia del Cuerpo Calloso/diagnóstico , Cuerpo Calloso/diagnóstico por imagen , Ultrasonografía Prenatal , Femenino , Feto , Edad Gestacional , Humanos , Embarazo , Primer Trimestre del Embarazo , Estudios RetrospectivosRESUMEN
OBJECTIVE: To evaluate the perinatal management and outcome of different types of fetal arrhythmia. METHODS: A retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a single institution between October 2003 and December 2010. RESULTS: A total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia during pregnancy was extrasystole (n=59), followed by bradycardia (n=23), tachycardia (n=16), atrial flutter (AF, n=3), atrioventricular block (AVB, n=12) and other arrhythmia (n=17). The overall incidence of cardiac anomalies (commonly fetal bradycardia) was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia (P=0.024), presence of congenital heart defect (CHD, P=0.000) and fetal hydrops (P=0.008) were significant risk factors associated with termination of pregnancy. CONCLUSION: Fetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination.
Asunto(s)
Arritmias Cardíacas/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen , Adulto , Arritmias Cardíacas/clasificación , Femenino , Cardiopatías Congénitas/diagnóstico por imagen , Humanos , Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Estudios Retrospectivos , Ultrasonografía Doppler en Color , Ultrasonografía Prenatal , Adulto JovenRESUMEN
OBJECTIVE: To study the value of prenatal ultrasound in the diagnosis of fetal malformations. METHODS: We retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006. RESULTS: The incidence rate of fetal malformation was 22.5 per thousand in our study group. The detection rate of prenatal ultrasound was 79.02% (1 062/1 344), among which the detection rate of the severe malformations (87.58%, 860/982) were significantly higher than that of the minor malformations (55.80%, 202/362) (P < 0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities. CONCLUSION: Prenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.