Maternal Th17/Treg Cytokines and Small Extracellular Vesicles in Plasma as Potential Biomarkers for Preeclampsia.

Preeclampsia is one of the most serious pregnancy complications. It may be caused by immunological changes in the early placental microenvironment. The contents of small EVs may serve as biomarkers of pregnancy complications. Evidence suggests that the balance between T helper 17 (Th17) and regulatory T (Treg) cells are critical for preventing preeclampsia. The study recruited 39 pregnant women with preeclampsia and 127 healthy pregnant women. We assessed the levels of both Th17 and Treg cytokines (IL-10, IL-17, IL-21, IL-22, and TGF-ß) in their plasma and small EVs. We found significant differences in the levels of all cytokines in the plasma between the two groups during the second trimester. We also observed significant differences between the two groups in the levels of EV-encapsulated cytokines IL-21, IL-22, and TGF-ß, as well as in total small EVs, during the second trimester. The ROC analysis showed that the classification efficiency (AUC) of TGF-ß in small EVs was 0.81. TGF-ß had the best discriminant ability of all the single EV biomarkers tested, the cross-validation of the accuracy was 0.89. Th17 and Treg cytokines in plasma and small EVs may contribute to maternal immune activation and clarify the potential mechanisms of small EVs and cytokines in preeclampsia.

Hyaluronan Upregulates Mitochondrial Biogenesis and Reduces Adenoside Triphosphate Production for Efficient Mitochondrial Function in Slow-Proliferating Human Mesenchymal Stem Cells.

Hyaluronan-coated surfaces preserve the proliferation and differentiation potential of mesenchymal stem cells by prolonging their G1-phase transit, which maintains cells in a slow-proliferative mode. Mitochondria are known to play a crucial role in stem cell self-renewal and differentiation. In this study, for the first time, the metabolic mechanism underlying the hyaluronan-regulated slow-proliferative maintenance of stem cells was investigated by evaluating mitochondrial functions. Human placenta-derived mesenchymal stem cells (PDMSCs) cultured on hyaluronan-coated surfaces at 0.5, 3.0, 5.0, and 30 µg/cm2 were found to have an average 58% higher mitochondrial mass and an increase in mitochondrial DNA copy number compared to noncoated tissue culture surfaces (control), as well as a threefold increase in the gene expression of the mitochondrial biogenesis-related gene PGC-1α. Increase in mitochondrial biogenesis led to a hyaluronan dose-dependent increase in mitochondrial membrane potential, ATP content, and oxygen consumption rate, with reactive oxygen species levels shown to be at least three times lower compared to the control. Although hyaluronan seemed to favor mitochondrial function, cell entry into a hyaluronan-regulated slow-proliferative mode led to a fivefold reduction in ATP production and coupling efficiency levels. Together, these results suggest that hyaluronan-coated surfaces influence the metabolic proliferative state of stem cells by upregulating mitochondrial biogenesis and function with controlled ATP production. This more efficiently meets the energy requirements of slow-proliferating PDMSCs. A clear understanding of the metabolic mechanism induced by hyaluronan in stem cells will allow future applications that may overcome the current limitations faced in stem cell culture. Stem Cells 2016;34:2512-2524.

Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women.

Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness of listening to music at home in improving sleep quality, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for 2 weeks. The PSQI and State-Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the music listening group compared with the control group. The most frequently used music genre by participants in the experimental group was lullabies, followed by classical music and crystal baby music. This study supported the theory that 2-week music listening interventions may reduce stress, anxiety, and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants' journals also implied that the expectant mothers' choices of musical genres may correlate more with perceived prenatal benefits or the desire to interact with their unborn child.

The enhancement of biofilm formation in Group B streptococcal isolates at vaginal pH.

Group B streptococcus (GBS) is a common asymptomatic colonizer in acidic vagina of pregnant women and can transmit to newborns, causing neonatal pneumonia and meningitis. Biofilm formation is often associated with bacterial colonization and pathogenesis. Little is known about GBS biofilm and the effect of environmental stimuli on their growth along with biofilm formation. The objective of this study was to investigate the survival and biofilm formation of GBS, isolated from pregnant women, in nutrient-limited medium under various pH conditions. Growth and survival experiments were determined by optical density and viable counts. Crystal violet staining, scanning electron microscopy, and atomic force microscopy (AFM) were used to analyze the capacity of biofilm production. Our results showed that GBS isolates proliferated with increasing pH with highest maximum specific growth rate (µmax) at pH 6.5, but survived at pH 4.5 for longer than 48 h. Biofilm formation of the 80 GBS isolates at pH 4.5 was significantly higher than at pH 7.0. This difference was confirmed by two other methods. The low elastic modulus obtained from samples at pH 4.5 by AFM revealed the softness of biofilm; in contrast, little or no biofilm was measured at pH 7.0. Under acidic pH, the capability of biofilm formation of serotypes III and V showed statistically significant difference from serotypes Ia and Ib. Our finding suggested that survival and enhanced biofilm formation at vaginal pH are potentially advantageous for GBS in colonizing vagina and increase the risk of vaginosis and neonatal infection.

Soft tissue volume of upper arm in predicting small-for-gestational-age fetuses using three-dimensional ultrasound.

PURPOSE: To assess the value of fetal soft tissue volume (STV) of the upper arm in predicting small-for-gestational-age (SGA) fetuses using three-dimensional (3D) ultrasound (US). METHODS: We used 3D US to test the accuracy of fetal STV of the upper arm measurement in predicting SGA in a prospective cross-sectional study. RESULTS: Fetal STV of the upper arm assessed by 3D US can differentiate SGA fetuses from appropriate-for-gestational-age (AGA) fetuses. Using the 5th percentile as the cutoff, the sensitivity of fetal upper arm STV in predicting SGA fetuses was 84.1%, specificity, 93.4%, positive predictive value, 71.1%, negative predictive value, 96.8%, and overall accuracy, 91.9%. In addition, the diagnostic accuracy of fetal arm STV was better than that of the biparietal diameter, abdominal circumference, and femur length. CONCLUSION: Fetal STV of upper arm assessment by 3D US is a novel method to predict SGA fetuses.

Hyaluronan Induces a Mitochondrial Functional Switch in Fast-Proliferating Human Mesenchymal Stem.

BACKGROUND AND OBJECTIVES: Hyaluronan preserves the proliferation and differentiation potential of mesenchymal stem cells. Supplementation of low-concentration hyaluronan (SHA) in stem cells culture medium increases its proliferative rate, whereas coated-surface hyaluronan (CHA) maintains cells in a slow-proliferating mode. We have previously demonstrated that in CHA, the metabolic proliferative state of stem cells was influenced by upregulating mitochondrial biogenesis and function. However, the effect of SHA on stem cells' energetic status remains unknown. In this study, we demonstrate the effect that low-concentration SHA at 0.001 mg/ml (SHA0.001) and high-concentration SHA at 5 mg/ml (SHA5) exert on stem cells' mitochondrial function compared with CHA and noncoated tissue culture surface (control). METHODS AND RESULTS: Fast-proliferating human placenta-derived mesenchymal stem cells (PDMSCs) cultured on SHA0.001 exhibited reduced mitochondrial mass, lower mitochondrial DNA copy number, and lower oxygen consumption rate compared with slow-proliferating PDMSCs cultured on CHA at 5.0 (CHA5) or 30 µg/cm2 (CHA30). The reduced mitochondrial biogenesis observed in SHA0.001 was accompanied by a 2-fold increased ATP content and lactate production, suggesting that hyaluronan-induced fast-proliferating PDMSCs may rely less on mitochondrial function as an energy source and induce a mitochondrial functional switch to glycolysis. CONCLUSIONS: PDMSCs cultured on both CHA and SHA exhibited a reduction in reactive oxygen species levels. The results from this study clarify our understandings on the effect of hyaluronan on stem cells and provide important insights into the effect of distinct supplementation methods used during cell therapies.

Hyaluronan substratum induces multidrug resistance in human mesenchymal stem cells via CD44 signaling.

Little information is available concerning multidrug resistance (MDR) in mesenchymal stem cells, although several studies have reported that MDR is associated with hyaluronan in neoplastic cells. We have evaluated whether a hyaluronan-coated surface modulates MDR in placenta-derived human mesenchymal stem cells (PDMSCs). We have found that PDMSCs cultured on a tissue-culture polystyrene surface coated with 30 microg/cm(2) hyaluronan are more resistant than control PDMSCs to doxorubicin. Inhibiting PI3K/Akt signaling has shown that the PI3K/Akt pathway modulates both P-glycoprotein activity and doxorubicin resistance. In addition, 10 microM verapamil dramatically suppresses the doxorubicin resistance induced by the hyaluronan-coated surface, indicating that P-glycoprotein activity is necessary for MDR. We have further found that PDMSCs treated with CD44 small interfering RNA (siRNA) and grown on a polystyrene surface coated with 30 microg/cm(2) hyaluronan have fewer P-glycoprotein(+) cells and lower CD44 expression levels (less than 60% in both cases) than PDMSCs not treated with CD44 siRNA and grown on the hyaluronan-coated surface. Moreover, treatment with CD44 siRNA suppresses the hyaluronan-substratum-induced doxorubicin resistance. We conclude that a hyaluronan substratum induces MDR in PDMSCs through CD44 signaling.

Thanatophoric dysplasia: role of 3-dimensional sonography.

PURPOSE: Fetal thanatophoric dysplasia (TD) is a lethal skeletal dysplasia. Therefore, antenatal diagnosis of TD is mandatory in routine obstetrical care. However, because TD is relatively rare, prenatal detection is not an easy task. In the past, 2-dimensional (2D) sonography had been applied as the mainstay of prenatal diagnosis of TD. In this series, we report our work of detecting TD using 3-dimensional (3D) sonography. METHODS: We reviewed our computer database of prenatal diagnosis of TD in National Cheng Kung University Hospital from May 1995 to June 2006. All the cases were scanned using 2D and 3D sonography. In total, 9 cases of fetal TD were diagnosed. RESULTS: 3D sonography can detect fetal TD and provide additional vivid illustration after various modes of reconstruction that 2D sonography cannot afford. CONCLUSION: 3D sonography may contribute significantly to the detection of TD in utero and provide a novel visual depiction of this defect after reconstruction. Thus, 3D sonography may assist substantially in prenatal diagnosis as well as consultation.

Trypsin digest coupled with two-dimensional shotgun proteomics reveals the involvement of multiple signaling pathways in functional remodeling of late-gestation uteri in rats.

Pregnant uteri become quiescent after functional remodeling but details are not fully known. Here we revealed uterine proteins of late-gestation rats by 2-D shotgun proteomic analysis and correlated protein expression with uterine functions. After duplication, 239 proteins were identified. About 190 proteins commonly found in duplicate analyses were subjected to functional annotation. The proteins associated with signal transduction fell into three known pathways. Western blotting and functional data indicated that: (i) a reduction of Na(+)/K(+)-ATPase-related proteins was associated with the decrease of contraction rate, (ii) a reduction of tyrosine hydroxylase and cyclic AMP-dependent protein kinase type II-alpha regulatory chain (PKARII alpha) was associated with an increase in the relaxation response to 8-bromo-cAMP, and (iii) in the presence of Ras, an increased expression of nucleolin was associated with the elevation of Bcl-xL, an antiapoptotic protein. In conclusion, 2-D shotgun proteomic analysis provides a global database of uterine proteins for hypothesis-driven studies. Our data suggest that in late-gestation uteri down-regulation of PKARII alpha and Na(+)/K(+)-ATPase may cause functional remodeling and lead to uterine quiescent. Up-regulation of antiapoptotic proteins (nucleolin and Bcl-xL) in the Ras-mediated pathway may maintain cell survival and counteract cell loss during remodeling.

Hyaluronan substratum holds mesenchymal stem cells in slow-cycling mode by prolonging G1 phase.

We examined, in vitro, whether hyaluronan induces slow cycling in placenta-derived mesenchymal stem cells (PDMSCs) by comparing cell growth on a hyaluronan-coated surface with cell growth on a tissue-culture polystyrene surface. The hyaluronan-coated surface significantly downregulated the proliferation of PDMSCs, more of which were maintained in the G(0)/G(1) phases than were cells on the tissue-culture polystyrene surface. Both PKH-26 labeling and BrdU incorporation assays showed that most PDMSCs grown on a hyaluronan-coated surface duplicated during cultivation indicating that the hyaluronan-coated surface did not inhibit PDMSCs from entering the cell cycle. Mitotic synchronization showed that the G(1)-phase transit was prolonged in PDMSCs growing on a hyaluronan-coated surface. Increases in p27(Kip1) and p130 were the crucial factors that allowed hyaluronan to lengthen the G(1) phase. Thus, hyaluronan might be a promising candidate for maintaining stem cells in slow-cycling mode by prolonging their G(1)-phase transit.

Predicting fetal growth restriction with renal volume using 3-D ultrasound: efficacy evaluation.

Early detection and management of fetal growth restriction (FGR) is very important in prenatal care and daily practice, because FGR fetuses may suffer increased risk of perinatal morbidity and mortality. Renal volume (RV) might be one of the important parameters of fetal growth. Yet, no prenatal assessment of fetal RV in FGR fetuses by 3-D ultrasound (US) has been reported. We undertook a prospective and cross-sectional study using quantitative 3-D US to assess the efficacy of fetal RV in predicting FGR. All fetuses were singletons and were followed-up to delivery to determine whether they had FGR complications. In total, 221 fetuses without FGR and 28 fetuses with FGR were included. Our results showed fetal RV assessed by 3-D US can differentiate fetuses with FGR from fetuses without FGR. The best predicting threshold for FGR is at the tenth percentile of fetal RV. Using the tenth percentile as the cutoff, the efficacy of fetal RV in predicting FGR was sensitivity 96.4%, specificity 95.9%, positive predictive value 75.0%, negative predictive value 99.5% and accuracy 96.0%, respectively. Fetal RV assessed by 3-D US can be applied to detect FGR prenatally. We believe fetal RV assessment using 3-D US is a useful test in detecting fetuses with FGR.

Prenatal detection of fetal growth restriction by fetal femur volume: efficacy assessment using three-dimensional ultrasound.

As fetal growth restriction (FGR) may have increased risks with perinatal morbidity and mortality, it is very important to detect FGR prenatally. Fetal femur dysplasia is associated with a variety of congenital syndromes and FGR as well. To date, no prenatal assessment of fetal FV in predicting FGR using three-dimensional (3D) ultrasound (US) has been reported. In this study, we used 3D US to test the efficacy of fetal femur volume (FV) measurement in predicting FGR. We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and efficacy of fetal FV assessed by 3D US in detecting FGR according to the Bayes' theorem. All the fetuses were singletons and were followed up to delivery to determine whether they were complicated with FGR or not. In total, 304 fetuses without FGR and 42 fetuses with FGR were included for FV assessment in utero by 3D US. Our results showed fetal FV assessed by 3D US can differentiate fetuses with FGR from fetuses without FGR well. The best predicting threshold for FGR is at the 10th percentile of FV. Using the 10th percentile as the cutoff, the sensitivity of fetal FV in predicting FGR was 71.4%, specificity 94.1%, positive predictive value 62.5%, negative predictive value 96.0% and accuracy 91.3%. In addition, fetal FV is superior to fetal biparietal diameter and fetal abdominal circumference in predicting FGR. In conclusion, fetal FV assessed by 3D US can be applied to detect FGR well prenatally. We believe fetal FV assessment by 3D US would be a useful test in detecting fetuses with FGR.

Hyaluronan keeps mesenchymal stem cells quiescent and maintains the differentiation potential over time.

Hyaluronan (HA), an abundant polysaccharide found in human bodies, plays a role in the mesenchymal stem cells (MSCs) maintenance. We had previously found that HA prolonged the lifespan, and prevented the cellular aging of murine adipose-derived stromal cells. Recently, we had also summarized the potential pathways associated with HA regulation in human MSCs. In this study, we used the human placenta-derived MSCs (PDMSC) to investigate the effectiveness of HA in maintaining the PDMSC. We found that coating the culture surface coated with 30 µg cm-2 of HA (C) led to cluster growth of PDMSC, and maintained a higher number of PDMSC in quiescence compared to those grown on the normal tissue culture surface (T). PDMSC were treated for either 4 (short-term) or 19 (long-term) consecutive passages. PDMSC which were treated with HA for 19 consecutive passages had reduced cell enlargement, preserved MSCs biomarker expressions and osteogenic potential when compared to those grown only on T. The PDMSC transferred to T condition after long-term HA treatment showed preserved replicative capability compared to those on only T. The telomerase activity of the HA-treated PDMSC was also higher than that of untreated PDMSC. These data suggested a connection between HA and MSC maintenance. We suggest that HA might be regulating the distribution of cytoskeletal proteins on cell spreading in the event of quiescence to preserve MSC stemness. Maintenance of MSCs stemness delayed cellular aging, leading to the anti-aging phenotype of PDMSC.

Predicting fetal growth restriction with liver volume by three-dimensional ultrasound: efficacy evaluation.

It is well-documented that fetal growth restriction (FGR) may have increased risks of perinatal morbidity and mortality. Early detection of FGR is crucial in prenatal care and daily practice. We undertook a prospective and cross-sectional study using quantitative 3-D ultrasound (US) to assess the efficacy of fetal liver volume (LV) in predicting FGR. During the study period, 42 fetuses with FGR and 375 fetuses without FGR were included for the LV assessment in utero by 3-D US. All the fetuses were singletons and had follow-up to delivery to ensure whether they were complicated with FGR or not. Our results revealed that fetal LV assessed by 3-D US can differentiate well fetuses with FGR from those without FGR. The sensitivity of fetal LV in predicting FGR was 97.6%, with specificity 93.6%, predictive value of positive test 63%, predictive value of negative test 99.7% and accuracy 94%. In conclusion, fetal LV assessed by quantitative 3-D US can be used to predict fetuses with FGR antenatally. Our data support that fetal LV assessment by 3-D US would be a useful test in detecting fetuses with FGR.

Predicting fetal growth restriction by humerus volume: A three-dimensional ultrasound study.

Prenatal diagnosis of fetal growth restriction (FGR) is very important, as FGR may have increased risks with perinatal morbidity and mortality. Fetal humerus dysplasia is associated with a variety of congenital syndromes and FGR. For the assessment of the efficacy of fetal humerus volume in predicting FGR, we undertook a prospective cross-sectional study using quantitative three-dimensional (3D) ultrasound (US). In total, 42 fetuses with FGR and 258 fetuses without FGR were included for the humerus volume assessment in utero by 3D US. All the fetuses were singletons and were followed up to delivery to determine whether they were complicated with FGR or not. Our results revealed that fetal humerus volume assessed by 3D US can differentiate fetuses with FGR from fetuses without FGR well. The best predicting threshold for FGR is at the 10th percentile by humerus volume. Using the 10th percentile as the cutoff, the sensitivity of fetal humerus volume in predicting FGR was 97.6%, specificity 87.2%, positive predictive value 55.4%, negative predictive value 99.6% and accuracy 88.7%. In conclusion, fetal humerus volume assessed by quantitative 3D US can be used to predict FGR prenatally. We believe fetal humerus volume assessment by 3D US would be a useful test in detecting fetuses with FGR.

Differential Proteomic Analysis of Human Placenta-Derived Mesenchymal Stem Cells Cultured on Normal Tissue Culture Surface and Hyaluronan-Coated Surface.

Our previous results showed that hyaluronan (HA) preserved human placenta-derived mesenchymal stem cells (PDMSC) in a slow cell cycling mode similar to quiescence, the pristine state of stem cells in vivo, and HA was found to prevent murine adipose-derived mesenchymal stem cells from senescence. Here, stable isotope labeling by amino acid in cell culture (SILAC) proteomic profiling was used to evaluate the effects of HA on aging phenomenon in stem cells, comparing (1) old and young passage PDMSC cultured on normal tissue culture surface (TCS); (2) old passage on HA-coated surface (CHA) compared to TCS; (3) old and young passage on CHA. The results indicated that senescence-associated protein transgelin (TAGLN) was upregulated in old TCS. Protein CYR61, reportedly senescence-related, was downregulated in old CHA compared to old TCS. The SIRT1-interacting Nicotinamide phosphoribosyltransferase (NAMPT) increased by 2.23-fold in old CHA compared to old TCS, and is 0.48-fold lower in old TCS compared to young TCS. Results also indicated that components of endoplasmic reticulum associated degradation (ERAD) pathway were upregulated in old CHA compared to old TCS cells, potentially for overcoming stress to maintain cell function and suppress senescence. Our data points to pathways that may be targeted by HA to maintain stem cells youth.

Induction of VE-cadherin in rat placental trophoblasts by VEGF through a NO-dependent pathway.

Vascular endothelial-cadherin (VE-cadherin), a calcium-dependent homotypic adhesion molecule, contributes to endothelial assembly and VEGF-mediated survival during angiogenesis. In human term placentas, villous vessels and extravillous cytotrophoblasts express VE-cadherin. Therefore, the purpose of this study was to examine if VEGF modulated placental development by increasing the expression of VE-cadherin in rat placentas. Placental tissues from rats on gestation days 14 (G14), 18 (G18) and 21 (G21) were used. Western blot analysis and immunohistochemistry were performed to detect the protein abundance and the distribution of VE-cadherin. A nitric oxide analyzer was used to measure the released nitric oxide (NO) from placental explant culture. With the progression of pregnancy, the abundance of VE-cadherin and the intensity of the immunoreactive staining for VE-cadherin in endovascular trophoblasts and labyrinth trophoblasts were decreased. In explant culture, VEGF (0.01-1.0 ng/ml) increased the protein abundance of VE-cadherin. SNP (an NO donor) or L-arginine (substrate for eNOS) induced the expression of VE-cadherin with the increase of NO production. L-NAME (a NOS inhibitor) reduced the VEGF-increased expression and L-arginine reversed the inhibitory effect of L-NAME. In conclusion, VEGF plays an important role in placental development by the induction of VE-cadherin in trophoblasts, which, in part, maintains the survival of labyrinth trophoblast in rat placentas.

Fetal upper arm volume in predicting intrauterine growth restriction: a three-dimensional ultrasound study.

As fetuses with intrauterine growth restriction (IUGR) may have increased risks with perinatal morbidity and mortality, prenatal diagnosis of IUGR is a very important issue in perinatology. To assess the efficacy of fetal upper arm volume in predicting IUGR, we undertook a prospective, cross-sectional study using quantitative three-dimensional (3D) ultrasound (US). In total, 40 fetuses with IUGR and 442 fetuses without IUGR were included for the upper arm volume assessment in utero by 3D US. All the fetuses were singletons and were followed up to delivery to establish whether they were complicated with IUGR or not. Our results showed that fetal upper arm volume assessed by 3D US can differentiate fetuses with IUGR from fetuses without IUGR well. The best predicting threshold for IUGR is at the 10th percentile by upper arm volume. Using the 10th percentile as the cutoff, the sensitivity of fetal upper arm volume in predicting IUGR was 97.5%, with specificity 92.8%, predictive value of positive test 54.9%, predictive value of negative test 99.8% and accuracy 93.1%. Furthermore, upper arm volume is the best parameter for detecting IUGR among the common fetal biometric indices, such as biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW). In conclusion, fetal upper arm volume assessed by quantitative 3D US can be used to predict fetuses with IUGR antenatally. We believe fetal upper arm volume assessment by 3D US would be a useful test in detecting fetuses with IUGR.

The efficacy assessment of thigh volume in predicting intrauterine fetal growth restriction by three-dimensional ultrasound.

Intrauterine growth restriction (IUGR) is an important issue in perinatology. To assess the efficacy of fetal thigh volume (ThVol) in predicting IUGR, we undertook a prospective cross-sectional study using quantitative 3-D ultrasound (US). During the study period, 30 fetuses with IUGR and 282 fetuses with non-IUGR were included for the ThVol assessment in utero by 3-D US. All the fetuses were singletons and had follow-up to the delivery to determine whether they were complicated with IUGR or not. Our results showed fetal ThVol assessed by 3-D US can differentiate fetuses with IUGR from fetuses with non-IUGR well. Using the 10th percentile as the screening threshold, the sensitivity of fetal ThVol in predicting IUGR was 86.6%, with specificity 91.1%, predictive value of positive test 51.0%, predictive value of negative test 98.5% and accuracy 90.7%. In conclusion, fetal ThVol assessed by quantitative 3-D US can be used to predict fetuses with IUGR antenatally. We believe fetal ThVol assessment by 3-D US would be a useful test in detecting fetuses with IUGR.

Prenatal diagnosis of fetal acrania using three-dimensional ultrasound.

Fetal acrania is uniformly lethal and termination is suggested whenever the diagnosis is made. Traditionally, the diagnostic tool was 2-D ultrasound (US). In this series, we report our work of detecting acrania using 3-D US. We reviewed our medical records of prenatal diagnosis on fetal acrania in National Cheng Kung University Hospital from May 1997 to December 2002. All the cases were scanned by a 3-D US scanner. In total, 29 cases of fetal acrania were diagnosed. The range of gestational age at prenatal diagnosis by US was between 11 and 21 weeks and 44% were depicted in the first trimester. Among them, 93.1% were isolated findings, and one was associated with trisomy 18. Comparing with previous literature, 3-D US can detect fetal acrania as early as 2-D US, and it also can provide additional vivid illustration after various modes of reconstruction, which 2-D US cannot. In conclusion, 3-D US may contribute to early detection of fetal acrania and provide a novel visual depiction of this defect after reconstruction; thus, assists substantially in diagnosis as well as consultation.