1/15. prenatal diagnosis of dyssegmental dysplasia. A case report.BACKGROUND: Since the first use of sonography, most fetal dwarfism has been detectable prenatally. The correct differentiation of the subtype of dwarfism is difficult at times. Dyssegmental dysplasia is probably an exception to these subtypes because the vertebral disorganization and occipital encephalocele at times permits prenatal diagnosis. CASE: A 34-year-old woman, gravida 3, para 1, elective abortion 1 for dwarfism, was referred at 27 weeks' gestation for cystic hygroma. Further sonographic findings included: cystic hygroma with massive ascites, micromelia, occipital encephalocele, spinal disorganization and hydramnios. The fetus and both parents appeared to have a normal karyotype. Later the pregnancy was terminated with vaginal delivery. The fetus had micromelia, camptomelia, cystic hygroma, a flat face, short neck, short trunk, narrow thorax with protuberant abdomen, scoliosis and clubfeet. CONCLUSION: Sonography is effective in prenatal diagnosis of dyssegmental dysplasia. With sonography, diagnosis of dyssegmental dysplasia becomes possible as early as the first trimester.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
2/15. Renal lymphangiomatosis during pregnancy: management with percutaneous drainage.We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
3/15. MRI imaging of fetal neck masses with airway compromise: utility in delivery planning.We present two cases of fetal neck masses that were initially diagnosed by ultrasound and further evaluated with prenatal MRI. MRI findings aided in further delineating the neck masses, increasing confidence in the final diagnosis (cervical teratoma and cystic hygroma). With the fetal airway typically filled with fluid that is of high signal on T2-weighted sequences, MRI images in three planes could identify whether the fetal larynx and trachea were partially or completely compressed by the neck tumor. This information was particularly useful in determining if a controlled delivery such as ex utero intrapartum treatment (EXIT) was necessary and aided the surgeons in planning their approach to establishing airway control in the delivery room.- - - - - - - - - - ranking = 6keywords = delivery (Clic here for more details about this article) |
4/15. Fetal axillary cystic hygroma detected by prenatal ultrasonography: a case report.Fetal cystic hygroma is a rare developmental congenital anomaly of the lymphatic system, characterized by the formation of a multilocular, variable sized cystic mass. Most of cystic hygromas are found in the neck and other rare locations include axilla, mediastinum, and limbs. There are many papers about cystic hygroma colli, but there are only a few papers about fetal axillary cystic hygroma and no domestic papers. We present a case of fetal axillary cystic hygroma diagnosed antenatally followed by full-term delivery in a 30-yr-old woman. Operation was performed on the 8th day after birth and the mass was excised and confirmed as cystic hygroma.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
5/15. Antepartum assessment of fetal cystic lymphangioma by magnetic resonance imaging.Few reports of fetal cystic lymphangioma have described assessment in utero by magnetic resonance imaging (MRI). We evaluated a fetus with cystic lymphangioma by this method. Complementing the characteristic features of cystic lymphangioma in ultrasonographic images, prenatal MRI provided a detailed view of anatomic relationships of cysts to surrounding tissues in this case. This anatomic evaluation facilitated planning of perinatal management and choice of manner of delivery. We found MRI very helpful in antepartum assessment of fetal cystic lymphangioma.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
6/15. prenatal diagnosis of a giant foetal lymphangioma and haemangiolymphoma in the second trimester using 2D and 3D ultrasound.Lymphangiomas are benign tumours of the lymphatic system. Early prenatal diagnosis is important to permit a planned delivery and provide adequate postnatal care. It thereby improves prognosis and allows the option of terminating the pregnancy if poor outcome is predicted. We report two cases, a giant haemangiolymphoma and a lymphangioma. 2D and 3D US findings are presented and differential diagnosis, therapeutic options and prognosis are discussed.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
7/15. nitroglycerin for relaxation to establish a fetal airway (EXIT procedure).BACKGROUND: The ex utero intrapartum treatment (EXIT) procedure is a technique designed to establish an airway at the time of delivery in fetuses at risk of airway obstruction and requires maintenance of uterine relaxation to continue placental perfusion and prevent placental separation. We describe the use of intravenous nitroglycerin to maintain uterine relaxation during the EXIT procedure. CASE: A 17-year-old primigravida with a fetus known to have an anterior neck mass was admitted for a scheduled operative delivery at 38 weeks of gestation using a modified EXIT procedure. anesthesia was administered with a combined spinal-epidural technique. Intravenous nitroglycerin was administered as a bolus and then as a continuous infusion to maintain uterine relaxation until evaluation of the neonatal airway was completed. CONCLUSION: Intravenous nitroglycerin is an effective agent for maintenance of uterine relaxation and placental perfusion during the EXIT procedure.- - - - - - - - - - ranking = 2keywords = delivery (Clic here for more details about this article) |
8/15. The role of the surgeon in the case of a giant neck mass in the EXIT procedure.Large fetal neck masses can present a major challenge to securing an airway at birth, with associated risks of hypoxia, brain injury, and death. The authors report a case of a giant neck mass, diagnosed in a fetus of 28 weeks, treated through ex utero intrapartum treatment procedure to assist in securing an airway followed by excision of the mass on the day after delivery. A multidisciplinary team approach, combined with an accurate prenatal diagnosis obtained through fetal ultrasound magnetic resonance imaging examination, was the key to a successful outcome. The role of the pediatric surgeon was initially to secure the airways through a tracheostomy followed by excision of the mass when the infant's vital parameters had been stabilized.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
9/15. MR imaging and ultrasound of fetal cervical cystic lymphangioma: utility in antepartum treatment planning.We present a case of fetal cystic lymphangioma that was initially diagnosed by ultrasonography and further evaluated by prenatal MR imaging. MR imaging findings aided in improved delineation of the neck mass. T2-weighted MR images revealed partial compression of the airway by the neck mass. This information was useful in the decision to use ex utero intrapartum treatment (EXIT) and helped surgeons in planning their approach to establish airway control during delivery.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
10/15. prenatal diagnosis and management of massive bilateral axillary cystic lymphangioma.BACKGROUND: Fetal lymphangiomas can occur in many different anatomic locations, including the most commonly seen nuchal cystic hygroma. CASE: A fetus at 18 weeks' gestation was found to have a massive right axillary hygroma. The fetal karyotype was normal. Serial ultrasound examinations indicated progressive enlargement, but no hydrops. At 32 weeks' gestation, a left axillary hygroma was also diagnosed. The patient underwent cesarean delivery. CONCLUSION: prenatal diagnosis of nuchal cystic hygromas has a high association with karyotypic abnormalities, hydrops, and fetal demise; however, this association may not apply to cystic lymphangiomas at other locations.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
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