An enlarged fetal thymus may be the initial response to intrauterine inflammation in pregnant women at risk for preterm birth

SUMMARY OBJECTIVE: Fetal thymus involvement in prematurity has been studied, and this study aimed to evaluate its relationship with short cervix and amniotic fluid sludge in the second trimester of pregnancy. METHODS: In this prospective cross-sectional study, 79 pregnant women (19+0 to 24+6 weeks) were included, and cervical length and the presence or absence of amniotic fluid sludge were evaluated. In the three-vessel view of the fetal thorax, the thymus was identified, and its perimeter and transverse diameter were measured and transformed to a zeta score based on gestational age. RESULTS: Data from 22 women with short cervix (<25 mm) and 57 patients with normal cervix (≥25 mm) were analyzed. The transverse diameter of the fetal thymus was significantly greater in the short cervix group compared to that of the normal cervix group (z-score 2.708 vs. −0.043, p=0.003). There were no significant differences in the perimeter (z-score −0.039 vs. −0.071, p=0.890) or the transverse diameter (z-score 1.297 vs. −0.004, p=0.091) of the fetal thymus associated with the presence (n=21) or absence of sludge (n=58). CONCLUSION: A short cervix is associated with an increased transverse diameter of the fetal thymus during the second trimester of gestation.

Prenatal diagnosis of a giant epignathus teratoma in the third trimester of pregnancy using three-dimensional ultrasound and magnetic resonance imaging. Case report.

A 20-year-old nulliparous woman was referred due a cervical mass in the fetus in an ultrasound examination performed in the 25th week of pregnancy. The exam revealed an irregular, solid-cystic heterogeneous mass measuring 75x54 mm that came to the exterior through the mouth of the fetus. Three-dimensional ultrasound and magnetic resonance imaging confirmed the diagnosis of epignathus teratoma and the normal finding of the central nervous system. The patient was admitted at 28 weeks, in premature labor. Tocolysis, corticosteroid and amniotic fluid drainage were programmed to be performed before conducting ex utero intrapartum treatment (EXIT). However, there was premature rupture of membranes and the EXIT procedure was brought forward. After premature placental abruption, the newborn's birth was concluded. Tracheostomy was performed, but the newborn's condition progressed to bradycardia and death in a few minutes.