Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.

Objective:To investigate the clinical value of prenatal ultrasound in assessing fetal low-lying conus medullaris and prognostic factors.Methods:Prenatal ultrasound images and pregnancy outcomes were retrospectively analyzed for 54 pregnant women with fetal conus medullaris position below the third lumbar vertebra (L3) level detected by prenatal ultrasound at Chongqing Health Center for Women and Children from May 2017 to January 2024. Based on postnatal follow-up results (clinical symptoms, imaging data, or surgical findings within 5-year old), they were divided into normal (42 cases) and abnormal (12 cases) groups. Basic clinical data were collected, including initial conus medullaris position at first diagnosis (conus medullaris at L3 level defined as 3, between L3 and L4 as 3.5, and so on; at first sacral vertebra as 6, second sacral vertebra as 7), and changes in conus medullaris position during prenatal ultrasound or MRI follow-up. Independent sample t-tests and Chi square tests were used to compare changes in conus medullaris position, tethered cord phenomenon, and presence of spinal masses between groups. Results:The initial conus medullaris position in the abnormal group was significantly lower than in the normal group (4.7±1.5 vs. 3.7±0.4, t=－3.75, P<0.001), and the proportion of rising to L3 or above in utero was lower than in the normal group [2/9 vs. 78.1% (25/32), χ2=9.76, P=0.002]. The abnormal group had higher proportions of tethered cord phenomenon [5/12 vs. 0.0% (0/42), χ2=19.29, P<0.001] and spinal masses [9/12 vs. 2.4% (1/42), χ2=32.62, P<0.001] compared to the normal group. Among the abnormal group children, eight underwent postoperative surgery (three with tethered cord and meningocele, four with tethered cord and lipoma, one with tethered cord, meningocele, and lipoma), with an overall good postoperative prognosis. Conclusion:Prenatal ultrasound enables dynamic monitoring of fetal conus position, while characteristic findings (tethered cord signs and spinal masses) help identify potential tethered cord syndrome, providing crucial evidence for comprehensive prenatal evaluation and early intervention.

Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.

Objective:To investigate the clinical value of prenatal ultrasound in assessing fetal low-lying conus medullaris and prognostic factors.Methods:Prenatal ultrasound images and pregnancy outcomes were retrospectively analyzed for 54 pregnant women with fetal conus medullaris position below the third lumbar vertebra (L3) level detected by prenatal ultrasound at Chongqing Health Center for Women and Children from May 2017 to January 2024. Based on postnatal follow-up results (clinical symptoms, imaging data, or surgical findings within 5-year old), they were divided into normal (42 cases) and abnormal (12 cases) groups. Basic clinical data were collected, including initial conus medullaris position at first diagnosis (conus medullaris at L3 level defined as 3, between L3 and L4 as 3.5, and so on; at first sacral vertebra as 6, second sacral vertebra as 7), and changes in conus medullaris position during prenatal ultrasound or MRI follow-up. Independent sample t-tests and Chi square tests were used to compare changes in conus medullaris position, tethered cord phenomenon, and presence of spinal masses between groups. Results:The initial conus medullaris position in the abnormal group was significantly lower than in the normal group (4.7±1.5 vs. 3.7±0.4, t=－3.75, P<0.001), and the proportion of rising to L3 or above in utero was lower than in the normal group [2/9 vs. 78.1% (25/32), χ2=9.76, P=0.002]. The abnormal group had higher proportions of tethered cord phenomenon [5/12 vs. 0.0% (0/42), χ2=19.29, P<0.001] and spinal masses [9/12 vs. 2.4% (1/42), χ2=32.62, P<0.001] compared to the normal group. Among the abnormal group children, eight underwent postoperative surgery (three with tethered cord and meningocele, four with tethered cord and lipoma, one with tethered cord, meningocele, and lipoma), with an overall good postoperative prognosis. Conclusion:Prenatal ultrasound enables dynamic monitoring of fetal conus position, while characteristic findings (tethered cord signs and spinal masses) help identify potential tethered cord syndrome, providing crucial evidence for comprehensive prenatal evaluation and early intervention.

Objective:To summarize the prenatal ultrasonographic features of Beckwith- Wiedemann syndrome (BWS).Methods:This retrospective study retrieved the records of six cases with BWS from Women and Children's Hospital of Chongqing Medical University from January 2015 to December 2022, to analyze their ultrasonographic features, clinical features after birth or termination, and genetic test results using descriptive statistical analysis method.Results:Intrauterine overgrowth was found in all six fetuses by prenatal ultrasound, and the estimated fetal weights were higher for their gestational age. Prenatal ultrasound findings showed macroglossia and protrusion of tongue in five cases, hepatomegaly in four cases, enlarged kidney in four cases, thickened umbilical cord in three cases, and intestinal duplication in two cases. Genetic testing showed that all six cases were associated with genetic damage at the 11p15.5 chromosome region. Three pregnancies were terminated after the diagnosis, and the features of gross specimens were consistent with the prenatal diagnosis. The postnatal clinical manifestations of three live births were macrosomia and macroglossia, two of whom exhibited acromphalus.Conclusion:BWS should be considered when fetal overgrowth, visceral enlargement, macroglossia, and acromphalus are found by prenatal ultrasound.

Objective:To explore the establishment and effect of short-term training path for prenatal ultrasound diagnosticians in primary hospitals.Methods:A total of 105 trainees from in total 5 batches of the "prenatal ultrasound screening training base" in Chongqing were selected as the research objects, and a combination of multiple teaching methods was used to carry out specialized training for primary prenatal ultrasound screening doctors before and after training. Theoretical examinations and practical operation assessments were performed, and after training, remote image quality control and continuous improvement methods were established for trainees to assess training effectiveness. SPSS 21.0 was used for t test, Wilcoxon test and chi-square test. Results:After training, the results of the theoretical examinations and practical operation examinations of the trainees were higher than those before the training ( P<0.05), and after the completion of the training, the number of trainees who returned to their original units to carry out prenatal ultrasound examination, the average number of prenatal ultrasound examinations per month and the number of referrals to higher prenatal diagnosis centers of each trainee increased significantly ( P<0.05). Conclusion:The establishment of short-term training path for prenatal ultrasound diagnosis can effectively improve the professional theoretical knowledge and practical operation level of prenatal ultrasound doctors in primary hospitals, and greatly solve the problem of technical promotion under the shortage of grassroots hospitals.

Objective:To summarize the prenatal ultrasonographic features and prognosis of fetal umbilical-portal-systemic venous shunt (UPSVS).Methods:This retrospective study retrieved the records of 14 fetuses with UPSVS from Chongqing Health Center for Women and Children from January 2018 to September 2020, to describe their ultrasonographic features, concomitant malformations, chromosomal examination results, and follow-up.Results:All the 14 cases were classified into three types: Type Ⅰ ( n=2), the umbilical vein directly connected to the systemic venous detouring around the liver; Type Ⅱ ( n=2), the umbilical vein connected to the distal inferior vena cava instead of the left atrium after entering the liver through the ductus venosus; and Type Ⅲa ( n=10), those with an intrahepatic shunt, between the intrahepatic portal venous system and the hepatic vein. Of the 14 fetuses, 11 had normal chromosome test results, including four had serum screening of Down syndrome in the first trimester, four had non-invasive prenatal testing, and three had prenatal genetic diagnosis. Six cases were complicated by other system malformations. Fetal growth restriction and heart failure were found in four cases each. Four pregnancies were terminated due to other anomalies and the other 10 ended in live births with good prognosis for the fetuses. Conclusions:Special attention should be paid to the fetal umbilical- portal-venous system when there are unexplained fetal growth restriction, fetal heart failure, or abnormal blood vessels in the abdominal section of the fetus. UPSVS has typically ultrasonographic features, which can prenatally determine the shunt type and the integrity of the intrahepatic portal venous system. A full assessment of the intrauterine fetal condition and other malformations are of great value in prognostic counseling.

This paper reported a male newborn with Ebstein's anomaly complicated by type B Wolff-Parkinson-White syndrome. The baby was delivered at 39 weeks of gestation and diagnosed as Ebstein's anomaly complicated by type B Wolff-Parkinson-White syndrome 2 d after birth. He was improved and discharged after conservative management in the Department of Internal Medicine. No abnormality was found by fetal echocardiography at 20 weeks of gestation, while supraventricular tachycardia was diagnosed by M-mode ultrasonography at 38 weeks of gestation due to rapid fetal heart rate. In addition to hemodynamic changes,the abnormal cardiac structure in patients with Ebstein's anomaly may also lead to tachyarrhythmia. Therefore, in fetuses diagnosed with supraventricular tachycardia by prenatal ultrasound or children with type B Wolff-Parkinson-White syndrome detected by electrocardiogram after birth, tricuspid valve should be carefully scanned under echocardiography to avoid the missed diagnosis of Ebstein's anomaly.

Objective:To assess the urethral mobility of normal parous women in China and explore the impacts of related risk factors on it using translabial ultrasound.Methods:Females who met the inclusion criteria in 37 tertiary hospitals from February 2017 to August 2018 were included. All women underwent standardized translabial ultrasound examination and the urethral rotation angle (URA), bladder neck position at maximum Valsalva maneuver (BNP-V) and bladder neck descent (BND) were measured. Questionnaires were used to collect basic information including age, height, weight, body mass index (BMI), past medical history, maternity history, and urinary incontinence related history. Mann-Whitney U test and multiple linear regression analysis were adopted to explore the influences of age, BMI, delivery mode and parity on normal parous women′s urethral mobility. Then, the study subjects were divided into different groups and the corresponding values of URA, BNP-V and BND were compared. Results:Compared with parous women with normal BMI and no history of vaginal delivery, those who were overweight and/or had a history of vaginal delivery were more likely to gain greater URA and BND ( P<0.05). The URA and BND were not significantly different between women with different times of cesarean sections ( P>0.05); while for women with a history of vaginal delivery, these two parameters increased with the increase of the number of transvaginal deliveries ( P<0.05). Conclusions:BMI and vaginal delivery are important risk factors for the urethral mobility of normal parous women. The urethral mobility increases with the increase of BMI and the number of vaginal deliveries.

Human fetal heart is the difficulty in ultrasound standardized resident training, which involves embryogenesis, anatomy, fetal circulation characteristics, the mechanism of cardiac malformation and the points of ultrasonic diagnosis. This study investigated the application of missed and misdiagnosed case analysis in fetal heart teaching in ultrasound standardized resident training. The teacher selected the missed and misdiagnosed cases according to the teaching purpose, the students subsequently discussed, analyzed and reported the causes of missed and misdiagnosed cases, then the teacher combed and explained the key knowledge and extended knowledge points. According to the questionnaire survey, the students agreed that the analysis of missed and misdiagnosed cases can mobilize the enthusiasm of learning, help to understand the knowledge, and guide the future clinical work.