Prenatal Ultrasound Diagnosis and Clinical Analysis of Fetal Small Bowel Obstruction.

BACKGROUND: Fetal small bowel obstruction (SBO) is a serious condition with high morbidity and mortality rates. Prenatal ultrasound is an important tool for detecting SBO, but the optimal cutoff value for intestinal diameter remains undefined. OBJECTIVE: This study aimed to investigate the ultrasonic characteristics of fetal SBO and determine the optimal cutoff value for intestinal diameter to enhance prenatal ultrasound diagnosis. METHODS: We retrospectively analyzed the ultrasonic characteristics and postpartum data of 76 cases diagnosed with SBO. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cutoff value for dilated intestinal diameter. RESULTS: Among the 76 cases, 31 displayed the "double bubble sign" on ultrasound, with 20 cases identified as annular pancreas, 6 as duodenal atresia, and 5 as duodenal membranous stenosis. In 45 cases, the lesions were located in the jejunal or ileal segment and exhibited intestinal dilatation above the lesion site, including 27 cases of small bowel atresia, 7 cases of membranous jejunal stenosis, and 11 cases of small bowel volvulus. Out of the 76 cases, 9 showed no abnormalities after birth. ROC curve analysis determined optimal cutoff values of 17.5mm and 10.5mm for predicting "double bubble sign" lesions in the gastric and duodenal widths. For predicting small intestinal dilatation, the optimal cutoff values for dilated width and length of the intestinal tube were 11.5mm and 21.5mm, respectively, with high sensitivity and specificity. CONCLUSION: Ultrasonic imaging and changes in intestinal diameter provide valuable information for prenatal diagnosis and management of SBO. Establishing these cutoff values can improve the accuracy of prenatal ultrasound diagnosis for SBO.

Experience in prenatal ultrasound diagnosis of fetal microtia and associated abnormalities.

Objective: Prenatal ultrasound features, associated anomalies and genetic abnormalities of microtia cases were analyzed to explore the feasibility and value of prenatal ultrasound for the diagnosis of microtia. Methods: The ultrasonographic features, associated anomalies, chromosome examination results and follow-up results of 81 fetuses with congenital microtia were analyzed retrospectively. Results: Among the 81 fetuses with microtia diagnosed after birth, 2 cases were missed diagnosis on prenatal ultrasound, and 1 case was diagnosed as unilateral microtia by prenatal ultrasound but was found to be bilateral microtia after birth. Microtia was accompanied by an accessory auricle in 4 cases (4.94%) and low-set ears in 7 cases (8.64%). 22 cases (27.16%) were complicated with other structural anomalies, including 11 cases (13.58%) of cardiac anomalies, 7 cases (8.64%) of ultrasonographic soft marker anomalies, 6 cases (7.41%) of facial anomalies, 6 cases (7.41%) of nervous system anomalies, 3 cases (3.70%) of urogenital system anomalies, 3 cases (3.70%) of digestive tract anomalies and 2 cases (2.47%) of limb anomalies. Chromosome karyotype analysis and gene detection were performed in 44 cases. Trisomy 18, trisomy 13, trisomy 21, pericentric inversion of chromosome 9, partial loss of heterozygosity on chromosome 14, 22q11 microdeletion and a normal karyotype were found in 2 cases, 2 cases, 3 cases, 1 case, 1 case, 1 case, and 34 cases, respectively. Conclusion: In summary, microtia is often accompanied by congenital defects of other organs and structures, especially the heart and face, and prenatal ultrasound diagnosis of microtia and associated anomalies is of important clinical significance.

Absent pulmonary valve syndrome with tetralogy of fallot and patent ductus arteriosus at 14 weeks of gestation and follow-up 2 weeks later: Case report and review of literature.

Classical absent pulmonary valve syndrome (APVS) with tetralogy of fallot (TOF) is a rare congenital cardiac anomaly commonly associated with the absence of patent ductus arteriosus (PDA), which is mostly diagnosed after 20 weeks of gestation by fetal echocardiography. This case of APVS with TOF was suspected at 13 weeks of gestation and diagnosed at 14 weeks of gestation with an obvious PDA. The pulmonary arterial trunk and the branches did not dilate obviously. Fifteen days later, the PDA narrowed down with the discovery of pulmonary artery ectasia at the same time. This progress indicated that the absence of PDA is not necessary for the survival of APVS with TOF in utero, in contrast, the absence or restriction of PDA may be nothing less than adaptation to the disease. Fetal autopsy confirmed the accuracy of fetal echocardiography. Chromosome microarray analysis (CMA) showed 20p12 deletion in this fetus, which is rare among TOF cases.

New normal values not related to age and sex, of glomerular filtration rate by (99m)Tc-DTPA renal dynamic imaging, for the evaluation of living kidney graft donors.

The aim of this study was to investigate the normal values of glomerular filtration rate (GFR) by technetium-99m diaethylene-triamine-pentaacetic acid ((99m)Tc-DTPA) renal dynamic imaging for living kidney graft donors. In a total of 212 candidate donors, GFR was examined using (99m)Tc-DTPA renal dynamic imaging. Donors with GFR≥80mL/(min×1.73m(2)) and as low as with GFR≥70mL/(min×1.73m(2)) but a normal endogenous creatinine clearance rate (CCr) were quantified for living kidney donation. Differences in GFR levels based on sex and age were analyzed using rank correlation coefficient. Out of the 212 candidates, 161 were finally selected as kidney graft donors. The double kidney total GFR between the male and female donor groups, the GFR levels among differently-aged donor groups, and the GFR levels between the elderly (>55 years) and young- and middle-aged (≤55 years) donor groups did not show any significant difference (P>0.05). After kidney donation, renal function measured by blood urea nitrogen (BUN) and serum creatinine of all donors returned to normal within one week, and no serious complications were noticed. In conclusion, renal dynamic imaging by (99m)Tc-DTPA had a good accuracy and repeatability in GFR evaluation for living kidney donors. Candidate donors with GFR between 70mL/(min×1.73m(2)) and 80mL/(min×1.73m(2)) can be selected as kidney donors after strict screening. In living kidney donors GFR is not significantly correlated with age or sex.