Miniaturization of the sonographic transducer is clinically valuable for the diagnosis and treatment in obstetrics and gynecology, and transvaginal ultrasound has been widely used in gynecological examination. The application of laparoscopic and surgical ultrasound detectors can reduce complications or injuries. The application of three-dimensional ultrasound can clearly show fetal anatomic structures, providing a new way for prenatal diagnosis.
Gynecology ; methods ; Humans ; Laparoscopy ; methods ; Obstetrics ; methods ; Ultrasonography ; methods ; Ultrasonography, Interventional ; Ultrasonography, Prenatal

PURPOSE: Fast MRI has provided detailed and reproducible fetal anatomy. This study was performed to evaluate the usefulness of fetal MRI for prenatal diagnosis. MATERIALS AND METHODS: Fifty-six fetuses with congenital abnormalities on ultrasonography were evaluated by fetal MRI from 2001 to 2004 in Severance Hospital. Final diagnosis was made by postnatal pathology, postnatal MRI, and other modalities (such as ultrasound, retrograde pyelogram). A 1.5-Tesla superconductive MR imaging unit was used to obtain half-Fourier acquisition single-shot turbo spin images. RESULTS: Of the 56 fetuses, intracranial abnormalities were found in 26 fetuses, intraabdominal abnormalities in 17 fetuses, intrathoracic in 6 fetuses, head and neck in 5 fetuses, and other sites in 2 fetuses. There were six cases in which the diagnoses of fetal MRI and ultrasonography differed. In such cases, fetal MRI provided more exact diagnosis than ultrasonography (5 vs. 0). Three fetuses with intracranial abnormalities on ultrasonography were diagnosed as normal by fetal MRI and in postnatal diagnosis. CONCLUSION: Although ultrasonography is known as a screening modality of choice in the evaluation of fetus because of the cost-effectiveness and safety, the sonographic findings are occasionally inconclusive or insufficient for choosing the proper management. Thus, in this study, we suggest that fetal MRI is more useful than ultrasonography for the evaluation of intracranial abnormalities in some instances. For prenatal counseling and postnatal treatment planning, fetal MRI can be informative when prenatal ultrasonography is inadequate and doubtful.
Female ; Fetal Diseases/*diagnosis/ultrasonography ; Humans ; *Magnetic Resonance Imaging ; Pregnancy ; Prenatal Diagnosis/*methods ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Prenatal

PURPOSE: Existing ultrasound-based fetal weight estimation models have been shown to have high errors when used in the Indian population. Therefore, the primary objective of this study was to develop Indian population-based models for fetal weight estimation, and the secondary objective was to compare their performance against established models. METHODS: Retrospectively collected data from 173 cases were used in this study. The inclusion criteria were a live singleton pregnancy and an interval from the ultrasound scan to delivery of ≤7 days. Multiple stepwise regression (MSR) and lasso regression methods were used to derive fetal weight estimation models using a randomly selected training group (n=137) with cross-products of abdominal circumference (AC), biparietal diameter (BPD), head circumference (HC), and femur length (FL) as independent variables. In the validation group (n=36), the bootstrap method was used to compare the performance of the new models against 12 existing models. RESULTS: The equations for the best-fit models obtained using the MSR and lasso methods were as follows: log₁₀(EFW)=2.7843700+0.0004197(HC×AC)+0.0008545(AC×FL) and log₁₀(EFW)=2.38 70211110+0.0074323216(HC)+0.0186555940(AC)+0.0013463735(BPD×FL)+0.0004519715 (HC×FL), respectively. In the training group, both models had very low systematic errors of 0.01% (±7.74%) and −0.03% (±7.70%), respectively. In the validation group, the performance of these models was found to be significantly better than that of the existing models. CONCLUSION: The models presented in this study were found to be superior to existing models of ultrasound-based fetal weight estimation in the Indian population. We recommend a thorough evaluation of these models in independent studies.
Femur ; Fetal Weight* ; Head ; India ; Methods ; Models, Statistical ; Pregnancy ; Regression Analysis ; Retrospective Studies ; Ultrasonography* ; Ultrasonography, Prenatal

DNA Mutational Analysis ; methods ; Ellis-Van Creveld Syndrome ; diagnosis ; Female ; Humans ; Male ; Pregnancy ; Prenatal Diagnosis ; methods ; Proteins ; genetics ; Ultrasonography, Prenatal

BACKGROUNDRight dominant heart (RDH) in fetuses can occur with a number of cardiac as well as noncardiac anomalies. Analysis of the enlargement of the right cardiac chamber in the fetus remains a major challenge for sonographers and echocardiographers. The aim of this study was to report the experience with prenatal diagnosis of RDH in the fetuses over a 7-year period.

METHODSFetuses with prenatal diagnosis of RDH from July 2009 to July 2016 were evaluated in two different categories: according to the gestational age, Group I (n = 154, second trimester) and Group II (n = 298, third trimester); and according to the fetal echocardiography diagnosis, Group A (n = 452, abnormal cardiac structure) and Group B (n = 90, normal cardiac structure). Differences in categorical variables were assessed by Chi-square exact test and continuous variables were evaluated by independent Student's t-test or Mann-Whitney U-test depending on parametric or nonparametric nature of the data.

RESULTSOver a 7-year period, 452 fetuses were referred for the assessment of suspected RDH. Left-sided obstructive lesions were observed most frequently in the fetuses with RDH. When comparing Group I with Group II and Group A with Group B, the latter groups exhibited significant differences in the right/left ventricle (RV/LV) ratio (1.435 vs. 1.236, P = 0.002; 1.309 vs. 1.168, P = 0.047), RV width Z-score (1.626 vs. 1.104, P < 0.001; 1.553 vs. 0.814, P = 0.014), and above +2 cutoff percentages (14.3% vs. 22.5%; P = 0.038; 21.5% vs. 12.2%, P = 0.046). Multivariable logistic regression revealed no variables associated with perinatal survival.

CONCLUSIONSThe study demonstrates that RDH warrants careful attention to the possible presence of a structural cardiac anomaly, especially left-sided obstructive lesions. A diagnosis of RDH is best supported by a combination of the RV Z-score and RV/LV ratio. Most of the fetuses with RDH and structurally normal hearts had favorable outcomes.

Echocardiography ; Female ; Fetal Diseases ; diagnosis ; Fetal Heart ; abnormalities ; Heart Ventricles ; abnormalities ; Humans ; Pregnancy ; Prenatal Diagnosis ; methods ; Ultrasonography, Prenatal

We report the imaging findings in a case of fetal lymphangioma involving the retroperitoneum and right lower extremity, and diagnosed by ultrasonography and magnetic resonance (MR) imaging at 26 weeks of gestation. Prenatal ultrasonograms and T2-weighted single-shot fast spin-echo MR images clearly revealed an extensive, multilocular cystic mass with internal hemorrhage in the retroperitoneum extending to the lower extremity.
Abortion, Eugenic ; Adult ; Female ; Fetal Diseases/*pathology/*ultrasonography ; Human ; Lower Extremity/pathology/ultrasonography ; Lymphangioma/*pathology/*ultrasonography ; Magnetic Resonance Imaging/*methods ; Pregnancy ; Retroperitoneal Space/pathology/ultrasonography ; Ultrasonography, Prenatal

OBJECTIVETo assess the value of chromosomal karyotyping and array-based comparative genomic hybridization for the diagnosis of fetus with abnormalities detected by ultrasonography.

METHODSUmbilical cord blood samples were derived from 1 603 pregnant women. The samples were cultured for routine G-banding karyotype analysis. Among these, 792 samples have further subjected to array CGH analysis.

RESULTSAmong the 1 603 fetuses, 117 (7.30%) were found with chromosomal abnormalities. These included 72 numerical aberrations and 45 structural abnormalities, which respectively accounted for 4.49% and 2.81% of all cases. For those <35 years and ≥ 35 years, a significant difference has been found in terms of fetal chromosomal abnormalities (chi-square is 30.687, P< 0.01). And there was also a significant difference between those with isolated, two or multiple ultrasonographic markers (chi-square is 85.50, P< 0.01). Among 736 fetuses with a normal karyotype, array CGH has detected 17 (2.31%) with a microdeletion or microduplication.

CONCLUSIONKaryotype analysis and array CGH should be offered to all fetuses with ultrasonography detected anomalies regardless the number of markers.

Adolescent ; Adult ; Chromosome Aberrations ; Chromosome Disorders ; diagnosis ; genetics ; Comparative Genomic Hybridization ; methods ; Female ; Fetus ; abnormalities ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; methods ; Ultrasonography, Prenatal ; methods ; Young Adult

BACKGROUNDEvaluation of fetal central nervous system (CNS) agenesis by ultrasonography (US) is frequently limited, but magnetic resonance imaging (MRI) has its own advantages and is gaining popularity in displaying suspected fetal anomalies. The purpose of this study was to explore the value of MRI in detecting fetal CNS agenesis.

METHODSThirty-four women (aged from 22 to 35 years, average 27 years) with complicated pregnancies (16 - 39 weeks of gestation, average 30 weeks) were examined with a 1.5 T superconductive MR unit within 24 hours after ultrasonography. Half-Fourier acquisition single-shot turbo spin-echo (HASTE) T(2)-weighted imaging (T(2)WI) sequence were performed in all patients, and fast low angle shot (FLASH) T(1)-weighted imaging (T(1)WI) sequence were applied sequentially in seven of them. Comparison of the results was made between the MRI and US findings as well as autopsy or postnatal follow-up MRI findings.

RESULTSThe gyrus, sulcus, corpus callosum, thalamus, cerebellum, brainstem, and spinal cord of fetus were shown more clearly on T(2)-weighted MR images than on T(1)-weighted MR images. MRI corrected the diagnosis of US in 10 cases (10/34, 29.41%) and the diagnosis was missed only in 1 case (1/34, 2.94%).

CONCLUSIONMRI has advantages to US in detecting fetal CNS anomalies and is a supplement to US in complicated pregnancies.

Adult ; Central Nervous System ; abnormalities ; diagnostic imaging ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Pregnancy ; Ultrasonography, Prenatal

OBJECTIVE: To explore the value of ultrasonographic evaluation in fetal deformity in prenatal diagnosis by a systematic continuous sequence approach (SCSA). METHODS: Successive prenatal ultrasonographic evaluation was performed to monitor the whole anatomic structure,form, posture and movement of 16,685 fetuses during gestation aging 14 approximately 40(+3) weeks. RESULTS: Satisfactory ultrasonic images were obtained in 16,627 fetuses using the SCSA (99.65%). Of them, 514 abnormal fetuses were confirmed after subsequent labor or induced labor and 498 abnormal fetuses were correctly diagnosed using SCSA during prenatal stage (96.89%). Whereas 16 fetuses missed recognition (3.11%). Its sensitivity, specificity, positive and negative predictive value of diagnosis on fetal deformity were 96.98%, 99.96%, 98.66%, and 99.90 %, respectively. CONCLUSION SCSA in prenatal ultrasonographic evaluation of the fetal structure and malformation is reliable and accurate.
Adult ; Congenital Abnormalities ; diagnostic imaging ; Female ; Humans ; Pregnancy ; Sensitivity and Specificity ; Ultrasonography, Prenatal ; methods

OBJECTIVETo explore the ultrasound characteristics of intramural pregnancy and evaluate its diagnostic value.

METHODSIntramural pregnancy was diagnosed by endoluminal ultrasonography and confirmed by surgery and pathological examination in 6 patients. The position of the gestational sac, ultrasound findings, distribution of color Doppler flow signals were observed and analyzed together with their surgical and pathological results based on literature review.

RESULTSThere were three types of ultrasound characteristics: gestational cyst type, mass type and uterine rupture type. The gestational cyst type or mass type presented with an empty uterus and a gestational sac or mixed mass was found in the myometrium, which can be separated from the endometrium. The sac or mass did not communicate with the uterine cavity, and abundant blood flow was observed about the sac or in the mass, while massive hemoperitoneum was found in the uterine rupture type.

CONCLUSIONEndoluminal ultrasound is of high value in the diagnosis of intramural pregnancy.

Adult ; Endosonography ; Female ; Humans ; Myometrium ; diagnostic imaging ; Pregnancy ; Pregnancy, Ectopic ; diagnostic imaging ; Ultrasonography, Doppler, Color ; Ultrasonography, Prenatal ; methods