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 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.

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.

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.

Objective:To investigate the prenatal ultrasonic characteristics and hemodynamic changes of umbilical artery (UA) thrombosis in fetus, and to improve the accuracy of prenatal ultrasound diagnosis.Methods:The prenatal sonographic features and hemodynamic index of 5 cases with umbilical artery thrombosis(UAT) in Chongqing Health Center for Women and Children from January 2018 to April 2020 were analyzed and summarized retrospectively.Results:The absence of blood flow in one of the two UA was found in the third trimester of pregnancy while two UA were displayed in previous ultrasound scans and the blood flow of the UA on the right side of the bladder disappeared in 5 cases. The umbilical cord cross section showed three cavities in 5 cases. The long axis section of the umbilical cord showed hyperecho in one UA with no blood flow in 4 cases, and no exact hyperecho in the UA only showed no blood flow in 1 case. The UA systolic/diastolic velocity ratio(S/D)<2.0 and UA pulsatility index (PI)<5 th were observed in 5 cases. The middle cerebral artery (MCA) PI<5 th in 4 cases and 10 th

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.

Objective: To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome. Methods: The angles between trachea and bilateral bronchi were measured at 18-34⁺⁶ gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018. Scatter plots of left/right bronchus angle (α/β) ratios were drawn. Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test. Results: In the normal group, scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14, P<0.05), indicating that the right bronchus always went more steeply than the left one. In the case group, the α/β ratios were around 1.0. In the right group, the α value increased and was close to the β value [(153.90±5.43)° vs (156.02±5.59)°, t=-2.56, P>0.05] and presented as bilateral right bronchial angle; in the left group, the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56)°, t=-1.18, P>0.05] and presented as bilateral left bronchial angle. There were significant differences in the α and β values among the normal group, the right and left groups (all P<0.05), and the bronchial angles of the right group were both greater than those of the left group (all P<0.05). Conclusions Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

Objective To investigate the application value of DFY-Ⅱ ultrasound imaging analysis software in evaluation of fetal lung maturity in different pregnancy.Methods Totally 315 cases of healthy single pregnancies (24-41 weeks) were collected.The sonographic views of fetal right side sagittal plane were obtained.The echo intensity of fetal lung and liver were analyzed and the ratio was canculated with DFY-Ⅱ ultrasound imaging analysis software.Results The ratio of echo intensity from fetal lung and liver had positive correlation with gestational weeks (r=0.94,P＜0.05),the linear regression equation was Y=0.60+0.07X (r2 =0.883).Conclusion The ratio of echo intensity by fetal lung and liver analyzed with DFY-Ⅱ ultrasound imaging analysis software can be an effective method to evaluate fetal lung maturity.

Ovarian pregnancy is a rare ectopic pregnancy.In recent years,the development and popularization of assisted reproductive technology increase the incidence of ovarian pregnancy.This article focused on the ultrasound features of ovarian pregnancy following in vitro fertilization and embryo transfer (IVF-ET) by comparing those of pregnant corpus luteum and tubal pregnancy,and analyzed the advantages of transabdominal ultrasonography (TAS) and transvaginal ultrasonography (TVS) in the diagnosis.