11/37. Fetal intra-abdominal umbilical vein dilatation associated with notching in umbilical artery.INTRODUCTION: dilatation of the fetal intra-abdominal umbilical vein is a rare entity. It is unclear whether prenatally diagnosed umbilical vein dilatation is associated with an increased risk of fetal anomalies or poor perinatal outcome. Umbilical artery waveform notching may be a predictor of cord abnormalities. It seems reasonable following the baby closely after the diagnosis of both conditions. CASE REPORT AND DISCUSSION: We present here a new case diagnosed by ultrasonography at 30 weeks of gestation with normal fetal outcome and discuss the clinical features and the management of these rare abnormalities.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
12/37. Complete large bowel duplication with paraduodenal cyst: prenatal sonographic features.OBJECTIVES: To illustrate diagnostic dilemmas while considering a diagnosis of complete large bowel duplication and duodenal duplication cysts. methods: A case of large bowel dilatation with a peripancreatic cyst was identified sonographically in a 27-year-old gravida 3 at 35 weeks of gestation, suffering from gestational diabetes and pregnancy-induced hypertension. RESULTS: On the basis of sonographic findings of dilated, hyperperistaltic large bowel loops, and a large cyst with echo-free contents near the pancreas, a diagnosis of large bowel obstruction with a paraduodenal cyst was considered. The findings were confirmed after postnatal ultrasonography. At the time of surgery, it proved to be a completely duplicated large bowel with a paraduodenal cyst. CONCLUSION: Prenatal findings of a hugely dilated, hyperperistaltic large bowel should lead one to suspect/consider large bowel duplication. Associated cysts are likely to be bowel duplication cysts. Timely intervention can thus obviate potentially serious complications.- - - - - - - - - - ranking = 2.0822173617676keywords = gestation, pregnancy (Clic here for more details about this article) |
13/37. Massive multicystic dilatation of the uterine wall with myometrial venous thrombosis during pregnancy.We present a pregnancy complicated by multicystic dilatation of the uterine wall during the second trimester, leading to massive uterine distension, anemia and preterm cesarean section. The cystic changes detected by ultrasound and magnetic resonance imaging involved the whole uterine wall surrounding the entire amniotic cavity. Histopathological examination revealed the benign nature of the cystic changes, which represented dilated and thrombosed venous lacunae. Disturbed venous drainage, combined with local thrombosis, was likely to have led to the collection of a large volume of blood in the uterine wall and the subsequent multicystic change of the myometrium.- - - - - - - - - - ranking = 0.411086808838keywords = pregnancy (Clic here for more details about this article) |
14/37. Posterior sacculation of the uterus in a patient presenting with flank pain at 29 weeks of gestation.BACKGROUND: Uterine sacculation is a rare complication of pregnancy and may cause substantial peripartal morbidity. CASE: A possible diagnosis of posterior uterine sacculation was raised when a 34-year-old Gravida 1 Para 1 presented with bilateral flank pain at 29 weeks. Sonographic and magnetic resonance imaging findings confirmed the diagnosis and demonstrated bilateral dilated renal pelvises. Bilateral nephrostomas were placed, offering the patient considerable relief. A healthy female newborn was delivered by cesarean at 34 1/7 weeks. Operative findings confirmed the posterior sacculation of the uterus. CONCLUSION: early diagnosis of sacculation of the uterus is necessary to limit maternal and fetal morbidity and mortality. For a detailed evaluation of the pelvic anatomy, we recommend the use of magnetic resonance imaging in the third trimester.- - - - - - - - - - ranking = 4.0822173617676keywords = gestation, pregnancy (Clic here for more details about this article) |
15/37. First-trimester ultrasound diagnosis in a recurrent case of walker-warburg syndrome.We report on two siblings with walker-warburg syndrome (WWS) born to a consanguineous couple. In the index case, the second-trimester scan showed ventricular dilatation and we diagnosed WWS after observing retinal detachment at 26 weeks' gestation and lissencephaly by 32 weeks' gestation in addition to hypoplasia of the cerebellar vermis. The second case was first suspected at 12 weeks' gestation, when we observed a 2.8-mm nuchal translucency and an unusually large hindbrain vesicle. By 14 weeks' gestation, the lateral ventricles were clearly enlarged (12-13 mm), at 16 weeks' gestation the vitreous chamber appeared to be hyperechogenic, and by 17 weeks' gestation hydrocephalus was evident. The couple chose to continue the pregnancy, and during the third trimester lissencephaly, major hydrocephalus and polyhydramnios developed.Serial ultrasound examination should be offered to a family with a history of WWS and therefore a 1 in 4 risk of recurrence. In some cases, recurrence can be suspected as early as the first trimester, however the diagnosis cannot be excluded on the basis of normal ultrasound appearance until later in pregnancy.- - - - - - - - - - ranking = 6.1644347235352keywords = gestation, pregnancy (Clic here for more details about this article) |
16/37. prenatal diagnosis of fetal hydrometrocolpos secondary to a cloacal anomaly by magnetic resonance imaging.Fetal female urogenital anomalies are often difficult to evaluate by ultrasonography, especially in late gestation. We report a case of fetal hydrometrocolpos detected at 35 weeks of gestation. ultrasonography revealed a large retrovesical septate hypoechogenic mass in the fetal abdomen, however the sonographic findings were inconclusive. magnetic resonance imaging (MRI) confirmed that the abdominal mass was fluid-filled with a mid-plane septum in the midline posterior to the bladder, and showed a connection to the dilated uterus that was duplicated. These findings were consistent with a diagnosis of hydrometrocolpos with septate vagina and uterus didelphys. The neonate showed abdominal distension, ambiguous genitalia and anal atresia with a single perineal opening. Hydrometrocolpos was secondary to a urethral type of cloacal anomaly. Aspiration of the mass and a colostomy were performed on the first postnatal day, followed by anorectoplasty at 19 months of age. MRI is a useful complementary tool for assessing fetal urogenital anomalies when ultrasonography is inconclusive.- - - - - - - - - - ranking = 2keywords = gestation (Clic here for more details about this article) |
17/37. magnetic resonance imaging and proton magnetic resonance spectroscopy of megalencephaly and dilated Virchow-Robin spaces.Megalencephaly with dilated Virchow-Robin spaces has been suggested to represent a new clinical entity. This report describes two males and a female who have been monitored from pregnancy. The patients manifest a relatively normal psychomotor development with some minor neurologic symptoms such as mild muscle hypotonia and clumsy motor performance. Biochemical and electrophysiologic tests were normal. In the white matter of the brain, a prominent dilatation of the Virchow-Robin spaces with some adjacent signal alterations could be demonstrated by magnetic resonance imaging. magnetic resonance spectroscopy revealed normal metabolite concentrations in the cortical and deep gray matter and normal-appearing white matter. Affected white matter was characterized by mildly reduced to normal levels of myo-inositol and a decrease of all other metabolites including total N-acetyl moieties, choline-containing compounds, and total creatine. These data indicate that the dilatation of Virchow-Robin spaces reflects an underlying brain pathology causing neuroaxonal damage. Possible differential diagnoses are discussed.- - - - - - - - - - ranking = 0.082217361767601keywords = pregnancy (Clic here for more details about this article) |
18/37. Sonographic visualization of the ureter in pregnancy.We describe a method of differentiating physiological from pathological dilatation of the renal collecting system in pregnant patients. In physiological hydronephrosis the dilated ureter extends down only to the level of the common iliac artery. In 2 patients with distal ureteral stones a dilated ureter was visualized past the vessels. To determine the frequency and reliability of visualizing the ureters in pregnant patients 105 consecutive asymptomatic pregnant patients were examined. hydronephrosis was found in 83 kidneys in 59 of the patients. The dilated ureter was visualized in 64 of the renal units. The anatomy was well demonstrated by color flow Doppler scanning and in all of these cases the dilated ureter was seen to taper where it crossed the common iliac artery. These results suggest that the presence of a dilated ureter past the iliac artery is strong evidence for pathological distal ureteral obstruction in pregnancy.- - - - - - - - - - ranking = 0.411086808838keywords = pregnancy (Clic here for more details about this article) |
19/37. urinary tract dilatation in pregnancy.Right-sided ureteral and renal pelvis dilatation was observed during routine uterine ultrasonographic examination at 30 weeks' gestation. This continued to progress with the renal pelvis measuring 8.9 cm in diameter at 35 weeks, leading to early delivery. Renal function remained normal and these changes resolved completely after delivery.- - - - - - - - - - ranking = 1.3288694470704keywords = gestation, pregnancy (Clic here for more details about this article) |
20/37. Ultrasonographic assessment of intestinal damage in fetuses with gastroschisis: is it of clinical value?In cases of gastroschisis detected prenatally it has been proposed that ultrasonographic criteria may play an important role in the decision for early delivery. We evaluated five cases of gastroschisis diagnosed before birth and found a correlation between prenatally detected small bowel dilatation and severe intestinal damage. However, from the limited data available these in utero measurements seem to be ineffective as indicators for delivery intervention (1) because not all fetuses with bowel dilatation have postnatal evidence of intestinal damage, (2) because some infants with intestinal damage and a poor postnatal outcome may show no in utero evidence of bowel dilatation, (3) because initial bowel dilatation may occur before a gestational age when lung maturity is achieved, and (4) because, in those cases in which bowel dilatation did correlate with intestinal damage, the bowel was already beyond the point of salvage and the infant required bowel resection.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
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