[Thoracic manifestation of Klippel-Trenaunay syndrome. Case report and brief review of the literature]. / Thorakale Manifestation eines Klippel-Trenaunay-Syndroms. Fallbericht und kurze Literaturübersicht.

We report on prenatal diagnosis in a case of Klippel-Trenaunay syndrome with excessive tumour manifestations concerning thorax and upper extremities. The child was delivered at 37 weeks' gestation by cesarean section and, after several operations, is developing normally up to now.

Control of fetal size with multiple ultrasonic measurements.

I) Out of eight different bone and soft-tissue parameters, the abdominal circumference correlates best with the birth weight: r = 0.89. Only the combination of the abdominal and the thorax circumference has a better value: r = 0.91. However, all our parameters are linear. The employment of area or volume parameters would probably still improve fetal weight estimation. II) For diagnosing intrauterine growth retardation measurement of thigh diameter seems to be of some value. The quotients of soft-tissue parameters/bone parameters are partly independent of gestational age. Therefore they may support the diagnosis of small-for-date babies where gestational age is uncertain. Prospective studies with serial measurements should be carried out to verify the feasibility and practical utility of our parameters.

[The risks of amniocentesis in the second trimester of pregnancy (author's transl)]. / Uber Risiken der Amniozentese im zweiten Trimenon.

The results of 552 amniocenteses during the second trimester of pregnancy are reported. The amniocentesis were carried out under direct ultra-sonographic control. Six abnormal karyotypes were found and the pregnancies were terminated. Three spontaneous abortions due to intra-uterine infection following amniocentesis occurred. There were no maternal complications and no fetal injuries. 430 amniotic fluids were tested bacteriologically. Two samples showed E-coli and two samples grew staph epidermidis. The IGM values of 148 newborns with previous amniocentesis showed the same values as the IGM in newborns without amniocentesis during the pregnancy. Fetal monitoring prior and following the amniocentesis showed a temporary increase in uterine motility in 25% of the cases. Our observations and the review of the literature convinced us that complications of amniocentesis in the second trimester are rare. However, when complications occur the fetus and the pregnant woman are a serious risk. The fetal wastage caused by second trimester amniocentesis is approximately 0.5 to 1%. Therefore the patients must be informed about the risks very carefully prior to a second trimester amniocentesis.