Prenatal Assessment Of Fetuses Research Articles

Diaphragmatic Hernia as a Prenatal Feature of Glycosylphosphatidylinositol Biosynthesis Defects and the Overlap With Fryns Syndrome - Literature Review.

Fryns syndrome is an autosomal recessive multiple congenital anomaly syndrome, with diaphragmatic defects and secondary lung hypoplasia as cardinal features. Despite it was reported first in 1979, its exact etiology has not been established to date. With this review, we would like to draw attention to the prenatal presentation of multiple congenital anomalies syndromes, resulting from defects in the synthesis of glycosylphosphatidylinositol anchors, to be considered in a prenatal assessment of fetuses with DH and Fryns-like phenotype.

Investigation of Bone Ratios for Prenatal Fetal Assessment in Taiwanese Population

The purpose of this study is to calculate the ratios of fetal limb bone to nasal bone length (NBL) obtained by transabdominal ultrasound between 19 and 28 weeks of gestation. Cross-sectional data were obtained from 1408 women with singleton pregnancies who underwent an advanced prenatal ultrasound examination from August 2006 to September 2008. The single measurement plane of fetal limb bones was on the longest section of each structure with appropriate image magnification. To assess repeatability of the intraobserver, two repeated measurements were obtained in 44 fetuses. The ratio of fetuses with biparietal diameter (BPD)/NBL was compared with those of fetal limb bones/NBL. The mean ratio was found between fetal NBL measurements and BPD (7.240), humerus length (HL) (4.807), radius length (RL) (4.157), ulna length (UL) (4.502), femur length (FL) (5.131), tibia length (TL) (4.528), and fibula length (FiL) (4.507). The reference ranges of fetal long bone length/NBL ratios for the second trimester was established by transabdominal sonography. There were no significant increases in these ratios with gestational age, especially the HL/NBL ratio.

P51.15: Prenatal assessment of fetuses with congenital diaphragmatic hernia: experience of a referral centre

P51.15: Prenatal assessment of fetuses with congenital diaphragmatic hernia: experience of a referral centre

Fetal Ventriculomegaly Due to Isolated Brain Malformations

Management of 32 consecutive cases of fetal hydrocephalus diagnosed prenatally during a five years period is presented. Thirteen cases (40%) being patients with ventriculomegaly due to isolated brain malformation are the topic of this paper. In this group, management was conservative and consisted of termination of pregnancy by elective cesarean section after prenatal fetal assessment. Agenesis of corpus callosum (6 cases) and Dandy-Walker malformation (7 cases) were the most common observed forms. Antenatal sonography improved intrauterine follow-up. Skillful perinatal management and support facilities after birth have been found a reliable approach to conservative management of fetal hydrocephalus by lacking of satisfactory techniques for in utero permanent cerebrospinal fluid shunting.

The determination of plasma and urinary estetrol (E4) for assessing fetal and neonatal prognosis (author's transl)

As estetrol (E4) is believed to be the steroid most likely to wholly dependent on fetal origin, we developed a radiommunoassay for unconjugated and conjugated E4 (E4-U and E4-G) and investigated plasma and urinary levels serially throughout the second half of pregnancy to establish their validity by means of monitoring or screening tests to assess fetal well-being. E4 exhibits a remarkable increase during the latter half of pregnancy. At term, the mean E4-U level in maternal peripheral plasma was 0.67 +/- 0.33 ng/ml, a five fold increase from that at 28 weeks; E4-G was 4.57 +/- 2.84 ng/ml, showing a four fold increase; and E4-G levels in maternal urine were 1.68 +/- 0.96 mg/day, showing a three fold increase from that at 28 weeks. E4-U and E4-G levels showed no diurnal change. The coefficient of the correlation between plasma E4-U and E4-G was 0.699, which is satisfactory, but no correlation was found between urinary and plasma E4 levels. A significant correlation was shown between maternal and umbilical E4-U (r=0.820) and E4-G (r=0.608). No relationships between E4 levels and birth weight were detected. Pre-eclampsia, Rh-isoimmunization and diabetes mellitus are common complications of pregnancy which may cause latent fetal distress. Prenatal fetal assessment was performed by serial daily evaluations of these E4 values. In pre-eclampsia resulting in a small full term baby, E4 levels were mostly below normal mean values or failed to show an increased pattern. In addition, the E4 levels decreased in one case of neonatal death. In Rh-isoimmunization, plasma E4-G levels were lower in the group affected severely by the hemolytic desease. In a patient with diabetes mellitus delivered of a healthy baby, E4 levels were within the range of a normal pregnancy. In order to evaluate fetal and placental reserve capacities as well as feto-placental function, the dehydroepiandrosterone sulfate (DHA-S) loading test was performed by loading selected subjects with 50 mg of DHA-S, then serially measuring the E4 in the maternal plasma and urine. Intravenous infusion of 50 mg of DHA-S was completed in 60 minutes. A rapid and sharp increase of plasma E4 was observed, reaching maximal concentrations at 120 minutes in normal pregnancies. However, urinary levels showed patterns similar to those reported for estriol (E3). In some abnormal pregnancies, no increased or delayed patterns were observed in plasma E4-G levels, while the serial levels remained within the normal range. This possibly suggests that in these pregnancies, fetal functions had been inhibited or had reached their limit. It is concluded that the simultaneous determinations of serial E4 levels accompanied by the DHA-S loading test may be of value in assessing fetal well-being and reserve capacity and may therefore improve fetal and neonatal prognosis in abnormal pregnancies.