Prenatal diagnosis of fetal multiple hemivertebrae: the importance of 3D ultrasound assessment.

We herein present a case of fetal multiple hemivertebrae detected at antenatal sonography. The use of the 3 D technology supported by a new contrast enhancement rendering algorithm (Crystal Vue) has allowed the accurate prenatal classification of the defect, confirmed at follow up, that would have been difficult to define by 2 D only.

Prenatal diagnosis of caudal regression with heterotaxy syndrome: "A mermaid with a broken heart".

Caudal regression syndrome (CRS) is a rare congenital malformation with varying degrees of early gestational developmental failure. It is characterized by agenesis of the sacrum and lumbar spine, with lower limb neurological deficit and accompanying deformities of the pelvis, lower extremities, genitourinary, and gastrointestinal systems. We report a case of CRS associated with rare complex congenital heart defect, that is, heterotaxy syndrome, diagnosed prenatally.

The Embryonic Ascent of the Kidney Revisited.

Although the embryonic kidney's ascent is well established, the intermediate morphological changes that occur during the process are unclear. To evaluate the morphological events that accompany the kidney's ascent, we examined serial sagittal sections from 24 embryos at 5-7 weeks gestation. Six specimens had bilaterally ascending kidneys that were between the levels of the second to fifth lumbar vertebrae, and each kidney had a primitive renal cortex surrounding clusters of ampullae, which branched from the pelvis, and a dense tissue band that connected the renal cortex with the embryonic adrenal cortex or celiac ganglia, and there was no adipose capsule or renal artery. The tissue band contained abundant nerve twigs from the major splanchnic nerve; thus, it was conceivable that it was sufficiently rigid to support the length of the retroperitoneal tissue mass that included the embryonic adrenal cortex, celiac ganglia, and kidney. The lumbar vertebral body's height was much shorter than that of the ascending kidney. However, the lower vertebral column's curvature was often maintained, even when the kidneys had ascended. Therefore, vertebral column straightening was not the only factor required to drive the ascent. Together with the growth of the thorax and liver, the adrenal cortex, ganglia, and kidney appeared to change simultaneously at a position relative to the vertebrae. The renal artery established a connection to the renal cortex after the ascent. Evaluations of frontal sections from five additional specimens suggested that from its initial position, the kidney extended upwards between bilateral umbilical arteries. Anat Rec, 302:278-287, 2019. © 2018 The Authors. The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology published by Wiley Periodicals, Inc. on behalf of Wiley-Liss, Inc.

Absence of collagen IX accelerates hypertrophic differentiation in the embryonic mouse spine through a disturbance of the Ihh-PTHrP feedback loop.

Collagen IX (Col IX) is a component of the cartilage extracellular matrix and contributes to its structural integrity. Polymorphisms in the genes encoding the Col IX ɑ2- and ɑ3-chains are associated with early onset of disc degeneration. Col IX-deficient mice already display changes in the spine at the newborn stage and premature disc degeneration starting at 6 months of age. To determine the role of Col IX in early spine development and to identify molecular mechanisms underlying disc degeneration, the embryonic development of the spine was analyzed in Col IX -/- mice. Histological staining was used to show tissue morphology at different time points. Localization of extracellular matrix proteins as well as components of signaling pathways were analyzed by immunohistochemistry. Developing vertebral bodies of Col IX -/- mice were smaller and already appeared more compact at E12.5. At E15.5, vertebral bodies of Col IX -/- mice revealed an increased number of hypertrophic chondrocytes as well as enhanced staining for the terminal differentiation markers alkaline phosphatase and collagen X. This correlates with an imbalance in the Ihh-PTHrP signaling pathway at this time point, reflected by an increase of Ihh and a concomitant decrease of PTHrP expression. An accelerated hypertrophic differentiation caused by a disturbed Ihh-PTHrP signaling pathway may lead to a higher bone mineral density in the vertebral bodies of newborn Col IX -/- mice and, as a result, to the early onset of disc degeneration.

Ultrasonographic assessment of fetal growth in miniature "Shiba" goats (Capra hircus).

The aim of the present study was to monitor fetal growth in relation to gestational stage to generate formulae which could be used to estimate fetal age in goats. Eight miniature Shiba goats (Capra hircus) were examined weekly by transrectal and transabdominal ultrasound scanning during the gestation period between Day 21 and 126 days of gestation. For accurate judgment, all fetometric parameters were measured at least three times per one examination for each animal. Quantification of the growth of the fetus allowed the development of a number of predictors of fetal age. Low correlations were associated with measurement of the chest diameter (R(2)=0.869), trunk diameter (R(2)=0.8969), tibia length (R(2)=0.8662) and placentome diameter (R(2)=0.8999). Moderate correlation was assessed by calculation of the length of six successive lumbar vertebrae (R(2)=0.9296), femur length (R(2)=0.9278), heart axis length (R(2)=0.9382 and 0.9589; for the longitudinal and transverse axis, respectively), occipitonasal length (R(2)=0.9527), umbilical cord diameter (R(2)=0.9119) and orbit diameter (R(2)=0.9239). A high correlation was estimated in investigating the length of six successive thoracic vertebrae (R(2)=0.9674), braincase diameter (R(2)=0.9831) and crown rump length (R(2)=0.9848). In conclusion, the intrauterine fetal biometry estimation through ultrasound might be useful to predict the accurate gestational age in miniature goats.

Fetal development of the mesonephric artery in humans with reference to replacement by the adrenal and renal arteries.

According to the classical ladder theory, the mesonephric arteries (MAs) have a segmental arrangement and persist after regression of the mesonephros, with some of these vessels becoming definitive renal arteries. To avoid interruption of blood flow, such a vascular switching would require an intermediate stage in which two or more segmental MAs are connected to a definitive renal artery. To examine developmental changes, especially changes in the segmental distribution of MAs, we studied serial paraffin sections of 26 human embryos (approximately 5-7 weeks). At 5-6 weeks, 1-2 pairs of MAs ran anterolaterally or laterally within each of the lower thoracic vertebral segments, while 2-5 pairs of MAs were present in each of the lumbar vertebral segments, but they were usually asymmetrical. The initial metanephros, extending along the aorta from the first lumbar to first sacral vertebra, had no arterial supply despite the presence of multiple MAs running immediately anterior to it. Depending on increased sizes of the adrenal and metanephros, the MAs were reduced in number and restricted in levels from the twelfth thoracic to the second lumbar vertebra. The elimination of MAs first became evident at a level of the major, inferior parts of the metanephros. Therefore, a hypothetical arterial ladder was lost before development of glomeruli in the metanephros. At 7 weeks, after complete elimination of MAs, a pair of symmetrical renal arteries appeared near the superior end of the metanephros. In conclusion, the MAs appear not to persist to become a definitive renal artery.

A comprehensive review of the sub-axial ligaments of the vertebral column: part II histology and embryology.

BACKGROUND: As important as the vertebral ligaments are in maintaining the integrity of the spinal column and protecting the contents of the spinal canal, a single detailed review of their histology and embryology is missing in the literature. METHODS: A literature search using online search engines was conducted. RESULTS: Single comprehensive reviews of the histology and embryology of the spinal ligaments are not found in the extant medical literature. CONCLUSIONS: This review will be useful to those who study or treat patients with pathology of the spine.

Loss of NAC1 expression is associated with defective bony patterning in the murine vertebral axis.

NAC1 encoded by NACC1 is a member of the BTB/POZ family of proteins and participates in several pathobiological processes. However, its function during tissue development has not been elucidated. In this study, we compared homozygous null mutant Nacc1(-/-) and wild type Nacc1(+/+) mice to determine the consequences of diminished NAC1 expression. The most remarkable change in Nacc1(-/-) mice was a vertebral patterning defect in which most knockout animals exhibited a morphological transformation of the sixth lumbar vertebra (L6) into a sacral identity; thus, the total number of pre-sacral vertebrae was decreased by one (to 25) in Nacc1(-/-) mice. Heterozygous Nacc1(+/-) mice had an increased tendency to adopt an intermediate phenotype in which L6 underwent partial sacralization. Nacc1(-/-) mice also exhibited non-closure of the dorsal aspects of thoracic vertebrae T10-T12. Chondrocytes from Nacc1(+/+) mice expressed abundant NAC1 while Nacc1(-/-) chondrocytes had undetectable levels. Loss of NAC1 in Nacc1(-/-) mice was associated with significantly reduced chondrocyte migratory potential as well as decreased expression of matrilin-3 and matrilin-4, two cartilage-associated extracellular matrix proteins with roles in the development and homeostasis of cartilage and bone. These data suggest that NAC1 participates in the motility and differentiation of developing chondrocytes and cartilaginous tissues, and its expression is necessary to maintain normal axial patterning of murine skeleton.

New patterns of the growing L3 vertebra and its 3 ossification centers in human fetuses - a CT, digital, and statistical study.

BACKGROUND: This study describes reference data for L3 vertebra and its 3 ossification centers at varying gestational ages. MATERIAL AND METHODS: Using CT, digital-image analysis and statistics, the growth of L3 vertebra and its 3 ossification centers in 55 spontaneously aborted human fetuses aged 17-30 weeks was examined. RESULTS: Neither sex nor right-left significant differences were found. The height and transverse and sagittal diameters of the L3 vertebral body increased logarithmically. Its cross-sectional area followed linearly, whereas its volume increased parabolically. The transverse and sagittal diameters of the ossification center of the L3 vertebral body varied logarithmically, but its cross-sectional area and volume grew linearly. The ossification center-to-vertebral body volume ratio gradually declined with age. The neural ossification centers increased logarithmically in length and width, and proportionately in cross-sectional area and volume. CONCLUSIONS: With no sex differences, the growth dynamics of the L3 vertebral body follow logarithmically in height, sagittal and transverse diameters, linearly (in cross-sectional area), and parabolically (in volume). The growth dynamics of the 3 ossification centers of the L3 vertebra follow logarithmically in transverse and sagittal diameters, and linearly (in cross-sectional area and volume). The age-specific reference intervals of the L3 vertebra and its 3 ossification centers present the normative values of clinical importance in the diagnosis of congenital spinal defects.

Reference ranges for vertebral body areas of the fetal lumbosacral spine on 3-dimensional sonography using volume contrast imaging with OmniView.

OBJECTIVES; The purpose of this study was to establish reference ranges for vertebral body areas of the fetal lumbosacral spine in the coronal plane on 3-dimensional sonography using volume contrast imaging with OmniView (GE Healthcare, Zipf, Austria). METHODS; An observational cross-sectional study was conducted on 576 healthy pregnant women at gestational ages of 20 weeks to 34 weeks 6 days. Volume contrast imaging with OmniView was used to measure the vertebral body areas (L1-L5, S1, and S2) by positioning a curved line along the fetal lumbosacral spine. To create reference ranges, first- and second-degree linear regression models adjusted using residual analysis and the coefficient of determination (R(2)) were created. To assess reproducibility, two examiners evaluated 40 random volumes using the intraclass correlation coefficient. RESULTS; The mean areas of the vertebral bodies were 102.72 (range, 25-254), 107.29 (range, 30-245), 105.10 (range, 31-231), 99.09 (range, 31-211), 87.74 (range, 11-178), 65.80 (range, 18-161), and 46.54 (range, 12-129) mm(2) for L1, L2, L3, L4, L5, S1, and S2, respectively. In the intraobserver and interobserver reproducibility assessments, intraclass correlation coefficients of greater than 0.80 were found for all fetal vertebral body areas. CONCLUSIONS; Reference values for fetal lumbosacral spine vertebral body areas were determined by 3-dimensional sonography using volume contrast imaging with OmniView, and they were shown to be reproducible.

Differentiation of the nuclear groups in the posterior horn of the human embryonic spinal cord.

The formation of nuclear groups in the posterior horns of the human embryonic spinal cord was traced in serial sections of embryos of developmental stages 13 to 23 (32 to 56 postovulatory days). The following observations, new for the human, are presented: 1. The differentiation of the neural tube into 3 zones (germinal, mantle and marginal) is detected in the middle of the 5(th) week. 2. The primordia of the posterior horns are marked at stage 14 (33 days). 3. In the middle of the 7(th) week the nucleus proprius and substantia gelatinosa are discerned. 4. Differentiation of the nuclei within the posterior horns proceeds in the ventrodorsal and rostrocaudal gradients.

Morphometric analysis of lumbosacral canal in human foetuses / Análisis morfométrico del canal lumbosacro en fetos humanos

Lumbosacral part of the spinal canal requires special attention because this is the site commonly involved in spina bifida, tethered cord syndrome and some other pathologies like fatty tumours in the spine, cysts and syrinxes. The diagnosis as well as the treatment of neural tube defects mandates an accurate knowledge of morphometry of lumbosacral vertebral canal. There are various reports on radiological morphometric measurements in human foetuses by various authors but these possess inherent variability due to imaging techniques, patient positioning, observer's measuring techniques and normal and pathological variations. To overcome all these limitations, direct measurements by vernier calliper were preferred. 30 Formalin preserved human foetuses, of all age groups and both sexes, free of congenital craniovertebral anomalies, were obtained from the museum of Dept. of Anatomy, J. N. Medical College AMU Aligarh for the present study. Foetuses were divided into five groups (I-V) based on their gestational ages. Group I foetuses were of less than 17 weeks, II of 17-20 weeks, III of 21-25 weeks, IV of 26-30 weeks and V of more than 30 weeks. Each group contained 6 foetuses having both male and female, 3 each. Morphometric parameters taken into account were length of lumbar canal, maximum transverse diameters of lumbar vertebral canal at different vertebral levels, heights of the posterior surfaces of bodies of all lumbar vertebrae and length of sacral canal. Readings of adjacent groups were compared and results were analyzed by using Student's 't' test. Lumbar canal starts growing in length significantly in group III foetuses onward. There was consistency in the growth of lumbar canal diameters with gestational age at all levels. Heights of vertebral bodies of Ist two lumbar vertebrae showed variability in some adjacent groups. The same in the next three grew constantly with the growth of foetuses. Sacral canal showed variable growth in lengths in different grou...

La porción lumbosacra del canal espinal requiere una atención especial; es un sitio frecuentemente implicado en la espina bífida, el síndrome de médula anclada y algunas otras patologías como tumores de grasa en la columna vertebral, quistes y siringomelia. El diagnóstico y el tratamiento de los defectos del tubo neural requieren de un conocimiento preciso de la morfometría del canal vertebral lumbosacro. Existen diversos informes radiológicos sobre mediciones morfométricas en fetos humanos por parte de diversos investigadores, pero estos poseen una variabilidad inherente debido a las técnicas de imagen, posicionamiento del paciente, técnicas de medición del observador y, las variaciones normales y patológicas. Para superar todas estas limitaciones, para las mediciones directas se utilizó un caliper vernier. 30 fetos humanos conservados en formalina, de todas las edades y de ambos sexos, sin anomalías congénitas craneovertebrales, fueron obtenidos del museo del Departamento de Anatomía, J. N. Facultad de Medicina de la UMA, Aligarh. Los fetos fueron divididos en cinco grupos (I-V) sobre la base de su edad gestacional. El grupo I de fetos fueron los menores de 17 semanas, el II de 17-20 semanas, el III de 21-25 semanas, IV de 26 a 30 semanas, V de más de 30 semanas. Cada grupo contenía 6 fetos de ambos sexos (1:1/H:M)). Los parámetros morfométricos tomados en cuenta fueron la longitud del canal lumbar, el diámetro transversal máximo del canal vertebral lumbar en diferentes niveles, la altura de las superficies posteriores de los cuerpos de todas las vértebras lumbares y la longitud del canal sacro. Las mediciones de los grupos fueron comparadas y analizadas mediante el uso de la prueba de "t". El canal lumbar comenzó a aumentar en longitud significativamente desde el grupo de fetos III en adelante. No hubo consistencia en el crecimiento de los diámetros del canal lumbar con la edad gestacional en todos los niveles. Las alturas de los primeros dos cuerpos verte...

Colocalization in vivo and association in vitro of perlecan and elastin.

We have colocalized elastin and fibrillin-1 with perlecan in extracellular matrix of tensional and weight-bearing connective tissues. Elastin and fibrillin-1 were identified as prominent components of paraspinal blood vessels, and posterior longitudinal ligament in the human fetal spine and outer annulus fibrosus of the fetal intervertebral disc. We also colocalized perlecan with a synovial elastic basal lamina, where the attached synovial cells were observed to produce perlecan. Elastin, fibrillin-1 and perlecan were co-localized in the intima and media of small blood vessels in the synovium and in human fetal paraspinal blood vessels. Elastic fibers were observed at the insertion point of the anterior cruciate ligament to bone in the ovine stifle joint where they colocalized with perlecan. Elastin has not previously been reported to be spatially associated with perlecan in these tissues. Interactions between the tropoelastin and perlecan heparan sulfate chains were demonstrated using quartz crystal microbalance with dissipation solid phase binding studies. Electrostatic interactions through the heparan sulfate chains of perlecan and core protein mediated the interactions with tropoelastin, and were both important in the coacervation of tropoelastin and deposition of elastin onto perlecan immobilized on the chip surface. This may help us to understand the interactions which are expected to occur in vivo between the tropoelastin and perlecan to facilitate the deposition of elastin and formation of elastic microfibrils in situ and would be consistent with the observed distributions of these components in a number of connective tissues.

Comparative immunolocalization of the elastin fiber-associated proteins fibrillin-1, LTBP-2, and MAGP-1 with components of the collagenous and proteoglycan matrix of the fetal human intervertebral disc.

STUDY DESIGN: A comparative immunolocalization study of elastin-associated proteins and established intervertebral disc (IVD) extracellular matrix (ECM) components. OBJECTIVE: To localize for the first time, elastic fiber­associated proteins with structural fibrillar components in the annulus fibrosus (AF) of the fetal IVD. SUMMARY OF BACKGROUND DATA: Elastin has been identified histochemically in adult bovine, human, and immature rat IVDs, and in fetal human IVDs using electron microscopy; however, no immunolocalization studies have been undertaken for associated components in human fetal IVDs. METHODS: En-bloc fixation of thoracolumbar spinal segments in formalin and Histochoice followed by standard histochemical processing, paraffin embedding, microtome sectioning, and identification of IVD ECM components using a range of specific mono- and polyclonal antibodies and bright-field and laser scanning confocal microscopy. RESULTS: The elastic fiber-associated proteins fibrillin-1, LTBP-2, and MAGP-1 were prominently immunolocalized in the outer lamellar layers of the AF of the human fetal IVD. Dual localization of selected components by confocal microscopy demonstrated that versican and LTBP-2 were colocalized with fibrillin-1 microfibrils in the AF lamellae with a similar distribution to the elastin fibers. LTBP-2 was also associated with pericellular perlecan in the outer AF. These interconnections between elastin-associated proteins resulted in an elastic network, which connected the AF cells with the adjacent cartilaginous vertebral bodies. CONCLUSION: Specific immunolocalization of fibrillin-1, MAGP-1, and versican with elastin in the outer AF of the fetal human IVD has been demonstrated. We deduce from the established distributions of the elastin-associated proteins and their known interactivities with matrix components that these stabilize and aid in the integration of the elastic fibers in the annular lamellae and may be responsible for the generation of tensional forces in the outer AF, which direct the assembly of this tissue.

Prenatal evaluation of the position of the fetal conus medullaris.

OBJECTIVES: To determine the position of the fetal conus medullaris during pregnancy in relation to the last vertebral body and to examine its use in detecting skin-covered spinal dysraphism. METHODS: This was a retrospective study involving 300 consecutive ultrasound examinations between 15 weeks of gestation and term. Two operators independently assessed images of the spine to determine whether the conus medullaris and the last vertebral body could be visualized in a single image in a midsagittal plane. The distance between these two landmarks (the conus distance) was measured twice by both operators who were not aware of any previous measurements. Intra- and interobserver variability was assessed by 95% limits of agreement. Linear regression analysis was used to determine the relevant contributors to the conus distance and a normal range was computed based on the best-fit model. The normal results were compared with five cases of prenatally detected skin-covered spinal dysraphism. RESULTS: In 84.7% of the 300 cases, both operators were able to visualize the conus medullaris and the last vertebral body. Ninety-five percent limits of agreement for the intraobserver variability in measurement of conus distance were ± 1.9 mm. For the interobserver variability, they were - 3.7 and 2.5 mm. We found a linear relationship between conus distance and gestational age, biparietal diameter and abdominal circumference. The strongest relationship was observed for femur length (conus distance = - 8.2 + femur length (mm)). In the five abnormal cases, conus distance was well below the 5(th) percentile. CONCLUSIONS: Determination of conus distance allows for an objective and feasible assessment of the conus medullaris position. This parameter promises to be useful in the prenatal detection of skin-covered spinal dysraphism.

Contribution of the anterior longitudinal ligament to ossification and growth of the vertebral body: an immunohistochemical study using the human fetal lumbar vertebrae.

Using 15 mid-term human fetuses, we examined the role of the spine anterior and posterior longitudinal ligaments (ALL, PLL) in ossification of the lumbar vertebral body. By 18 weeks, a pair of calcified tissue or cortical walls had developed on the anterior and posterior sides of the ossification center. These calcified cortical walls were more highly eosinophilic than trabecular or woven bone in the ossification center. Vimentin-positive osteoblasts were arranged in line along the outer surface of the walls. However, few CD68-positive osteoclasts were evident around the walls, suggesting that the calcification in the walls was similar to periosteal ossification. The anterior cortical wall was connected tightly with the ALL by fiber bundles, but the posterior wall was separated from the PLL by the basivertebral (central) vein and loose tissues. Notably, by 30 weeks, the anterior cortical wall had become attached to and incorporated into the ALL. Thus, the ALL seemed to act as an active periosteum for ossification. Although our materials were limited in number and stage, we hypothesized that, in contrast to the PLL, the mature anterior cortical wall corresponds to a calcified fibrocartilage adjacent to the ALL and forms a bone-ligament interface maintaining an ossification potential.

Size and location of the kidneys during the fetal period.

PURPOSE: The aim of this study was to determine the morphometric development and location of the kidneys during the fetal period. METHODS: Three hundred and forty-four fetal kidneys, obtained from 172 human fetuses and aged between 9 and 40 weeks, were used in this study. Fetuses were divided into four groups according to the gestational weeks: first trimester, second trimester, third trimester, and full-term gestation. First, the anterior abdominal wall was dissected. Topographic localization of the kidneys in the abdominal cavity was then assessed. The distance between the inferior pole of the kidney and iliac crest was measured. The vertebral levels of the superior and the inferior poles and relations to ribs of the kidneys were determined. The distances between hilum of the kidneys and inferior vena cava, abdominal aorta, and midline of the vertebral column were determined. The dimensions (width, length, and thickness), weight, and volume of kidneys were measured. RESULTS: The results showed that the distance between the inferior poles of the kidneys and the iliac crest increases with gestational age. The vertebral levels of the superior and inferior poles of the kidneys increased during the fetal period. The level of the left kidney was higher than the level of the right kidney in the fetal period. The posterior surface relations to the ribs showed certain ascendance during gestation, corresponding to vertebral levels. However, fetal kidneys do not reach the same level as adults at full term. The kidneys move farther apart from the midline of the body during the fetal period. The dimensions, weight, and volume of the kidneys increased with gestational age during the fetal period. The ratio between kidney weights and fetal body weights were determined, and we observed that the ratio decreased during the fetal period. There were no sex or laterality differences in any parameter. CONCLUSIONS: The morphometric parameters and the location of the fetal kidneys were determined by the present study. This will also contribute to imaging of fetal kidneys and detection of kidney abnormalities in the intrauterine period. We hope that the present results can provide some useful findings for radiological (ultrasound and MR) studies.

Formation of the vertebral arches of the cervical, thoracic and lumbar vertebrae in early human foetuses.

Fusion of the neural arches was studied in 6 serially sectioned human foetuses aged 9 and 10 weeks. In foetuses of 9 weeks, the completion of arches was observed in the cervical, upper thoracic, and middle thoracic regions of the vertebral column. During the 10th week of development, fusion of neural processes progresses in the lower thoracic and upper three lumbar vertebrae.

Sonographic evaluation of the fetal conus medullaris at 20 to 24 weeks' gestation.

OBJECTIVE: To determine the normal level of the conus medullaris (CM) of the spinal cord of normal fetuses at 20 to 24 weeks' gestation using abdominal sonography. METHODS: Using a 4 to 8 MHz ultrasound abdominal transducer, CM was imaged in the midsagittal plane with the fetal spine facing toward the transducer. The CM ending level was located by counting the vertebrae caudal starting at T12, which was identified by lowest fetal rib. The CM locations were defined according to their positions relative to the vertebrae. RESULTS: One hundred and ten consecutive pregnant women were included in the study. The CM was clearly demonstrated in 78 (71%) of these cases. Most of the scanned fetuses had the CM ending height adjacent to vertebrae L2, L2-3 inter-space and L3 (73/78, 93%). The L1-2, L2, L2-3, and L3 vertebral groups did not differ in mean gestational weeks, maternal age, or fetal gender. CONCLUSION: The level of the CM can be determined at 20 to 24 weeks' gestation in about 70% of fetuses. Most of the scanned fetuses had the CM ending height adjacent to vertebrae L2, L2-3 vertebral space, and L3 (73/78, 93%). When detected lower than the third lumbar vertebra it should prompt prenatal and postnatal surveillance.

Occurrence and fate of fetal lumbar rib induced by Scutellariae radix in rats.

BACKGROUND: This study was conducted to evaluate the occurrence and fate of fetal lumbar rib induced by Scutellariae radix (SR) in rats. METHODS: Water extracts of SR were orally administered to pregnant rats from day 7 to day 17 of gestation at a dose of 186 mg/kg/day, equivalent to 25 g/kg of starting material, representing a 100-fold increase over typical human intake level. RESULTS: The incidence of fetal lumbar rib in the SR-treated group was increased on gestational day 20 and then decreased on postnatal day 50. The weight of fetuses in the SR-treated group tended to be less than that in the control group. Alkaline phosphatase in SR-treated dams was increased on gestational day 20, but was decreased on postnatal day 50. There were no significant differences between the vehicle control and SR-treated groups in maternal body weight, embryological, histopathological, hematological, and serum biochemical changes. CONCLUSIONS: The present data suggest that the appearance of lumbar rib induced by SR is a transient fetal variation rather than teratogenicity or maternal toxicity.