Is There a Difference in Sonographic Estimation of Amniotic Fluid Volume When Measuring With the Probe Perpendicular to the Floor Compared With Perpendicular to the Uterine Contour?

OBJECTIVE: This study sought to determine whether there is a significant difference in amniotic fluid measurements when measuring perpendicular to the floor compared with perpendicular to the uterine contour using both amniotic fluid index and single deepest pocket. METHODS: This was a single-centre, prospective study of women with singleton gestation who were undergoing fetal ultrasound examination. A total of 240 women were enrolled, and single deepest pocket and amniotic fluid index were measured with both techniques. Correlation coefficient and intraclass correlation coefficient were used to assess the agreement between the values using the two methods of measurement (Canadian Task Force Classification II-2). RESULTS: A strong correlation was found between amniotic fluid index measurements (correlation coefficient 0.82; intraclass correlation coefficient 0.7). A strong correlation also was found between single deepest pocket measurements (correlation coefficient 0.7; intraclass correlation coefficient 0.6). CONCLUSION: The measurement of amniotic fluid index and single deepest pocket can be performed either perpendicular to the floor or perpendicular to the uterine contour. There is no significant difference between these measurements and they correlate well.

Sonographic Markers in the Prediction of Fetal Complex Gastroschisis.

OBJECTIVE: To investigate the ultrasound (US) markers predictive of complex gastroschisis (CG), mortality, and morbidity in fetuses with gastroschisis. MATERIALS AND METHODS: This was a retrospective cohort study of 186 pregnancies with isolated fetal gastroschisis. Eight US markers were analyzed. The predictions and associations of US markers with CG, mortality, and morbidity were assessed. Combinations of US markers predictive of CG were investigated. RESULTS: Extra-abdominal bowel dilatation (EABD), intra-abdominal bowel dilatation (IABD), and polyhydramnios were predictive of CG. EABD between 25 and 28 weeks had a sensitivity of 64%, a specificity of 89%, a positive predictive value (PPV) of 56.2%, and negative predictive value (NPV) of 91.8%. The predictions of IABD were sensitivity = 26.7%, specificity = 96.7%, PPV = 61.5%, and NPV = 86.8%. The odds ratios for CG in the presence of 1 and 2 US markers, compared with the absence of a US marker, were 18.3 (95% CI, 3.83-87.64) and 73.3 (95% CI, 6.14-876), respectively. CONCLUSION: US markers predictive of CG were established. The combination of these markers increases the probability of CG.

[Giant chorioangioma and its perinatal complications. A report of a case]. / Corioangioma gigante y sus complicaciones perinatales. Reporte de un caso.

It is presented a clinical case of a pregnant patient, who attended to the hospital's emergency service because of the presence of transvaginal liquid. A polyhidramnios was diagnosed, due to a placental chorioangioma (of approximately 7 cm), which was confirmed by hystopatological examination, reporting placental chorioangioma with its three histological types: cellular, angioblastic and degenerative. The case and its complications, such as polyhidramnios, membranes rupture and preterm labor, are analized. Existing literature is reviewed.

Prenatal diagnosis of a benign facial tumor.

We report a case of prenatal diagnosis of a benign fetal skin tumor on the chin made at 27 weeks of pregnancy by ultrasound scan. We report this case given the uncommon diagnosis and the unique fetal facial profile seen on ultrasound, resembling the image of an ancient Egyptian pharaoh which made us call it 'Ramses' sign' as a future mnemonic aid to sonographers.

[Ultrasonographic diagnosis of polyhydramnios and its association with congenital malformations]. / Diagnóstico ultrasonográfico de polihidramnios y su asociación con malformaciones congénitas.

We carried out a prospective study at the Hospital de Gineco-Obstetricia del Instituto Mexicano del Seguro Social, in León, Guanajuato in order to evaluate the association between polyhydramnios and fetal congenital anomalies. 200 women were included, 100 with polyhydramnios and 100 with normal amniotic fluid (control group). The diagnosis of polyhydramnios was made with ultrasound scanning using maximum vertical pocket technique and amniotic fluid index. The patients with polyhydramnios had an average maximum vertical pocket of 9.3 centimeters and amniotic fluid index of 27.0 centimeters. In patients with polyhydramnios 24 cases of congenital malformations were found, and none in patients with normal amniotic fluid (P < 0.01). The most common fetal anomalies were: esophageal atresia (25%), anencephaly (21%) and ductus arteriosus (21%). There were six perinatal deaths in the group of patients with polyhydramnios, five of them had congenital abnormalities, on the other hand in the control group there were no perinatal deaths (P < 0.01). Owing to the signifficative association between polyhydramnios and congenital anomalies, we suggest to reinforce the ultrasound evaluation in order to detect these abnormalities and to offer an early treatment and therefore a better prognosis to the fetus.

[Polyhydramnios and its relationship with congenital malformations: ultrasonographic diagnosis]. / Polihidramnios y su relación con malformaciones congénitas: diagnóstico ultrasonográfico.

We analyzed the occurrence of polyhydramnios during pregnancy and to indicate the association with congenital abnormalities of the product and maternal alterations. A retrospective descriptive and transversal study was performed which included 6087 pregnant patients who were submitted to ultrasonographic studies from January 1, 1991 to December 31, 1993. The final sample consisted of 72 patients with criteria of polyhydramnios and who had a complete, clinical history, specific data concerning the reproductive history and maternal risk factors associated with polyhydramnios and fetal malformations was compiled. The occurrence of polyhydramnios during pregnancy was 1.1% and the association with congenital malformations was 13.8%, being the majority neural tube defects. The maternal alterations were related in 13.7% to polyhydramnios, being primary cause gestational diabetes. Anencephalia presented a significant statistics (p < 0.05). The occurrence of polyhydramnios is low in obstetric patients. Neural tube defects such as anencephalia are the primary fetal defects. Gestational diabetes and multiple gestations are the more significant maternal alterations.

[First arch syndrome: ultrasonic diagnosis]. / Síndrome del primer arco: diagnóstico ultrasonográfico.

A facial malformation was diagnosed by ultrasonography, the case correspond to First Arch syndrome, the findings are micrognathia, polyhydramnios, low-set ears and absence of stomach bubble. The heterogeneity of this syndrome and his relationship with environmental agents is analyzed.