Detection of fetal major structural anomalies at the 11-14 ultrasound scan in an unselected population.

OBJECTIVE: The aim of the study was to determine the efficacy of the 11-14 week scan in detecting fetuses with structural anomalies. STUDY DESIGN AND METHODS: Prospective interventional study in an unselected population of pregnant women in a 5-year period (2003-2008) in a single ultrasound unit. 8889 fetuses with median CRL 65mm (45-84mm) were examined. Continuing pregnancies were rescanned at 20-22 weeks. Actual structural anomalies among newborns from the studied group were obtained from our computerized database. RESULTS: The median maternal age was 30 years (14-50 years). The incidence of anomalies was 16.08 per 1000 (143/8889). Of these, 99 of the 143 were detected with prenatal sonography. 46.9% (67/143) of all anomalies were detected at the 11-14 week scan. Later in pregnancy, another 22.3% (32/143) of structural anomalies were detected. CONCLUSIONS: 67.7% of all antenatally detected malformations by ultrasound were recognized in the 11 14 week scan. Obviously, the second trimester scan cannot be abandoned, as it provides effective detection of other anomalies.

[Intraumbilical therapy of fetal supraventricular tachycardia]. / Intraumbilikální lécba supraventrikulární tachykardie plodu.

The supraventricular tachycardia represents the life threatening disease, which may cause severe heart failure or even during foetal life. The authors present case report of the foetus aged 23 weeks of gestation in whom the supraventricular tachycardia was resistant to standard transplacental treatment by using digoxin and sotalol. The successful rhythm conversion was achieved by intracordal infusion of amiodarone. Further uncomplicated course of pregnancy reached term and healthy boy was subsequently born without having additional psychomotoric complications.

Extraction of radioactive rubidium and D-glucose from the artificially perfused intervillous space of the human placenta.

Extraction (Et) of 86Rb and [14C]D-glucose from the artificially perfused intervillous space of the human placenta was measured using [3H]L-glucose as a reference tracer. E. of 86Rb increased slowly from initial values near zero to a late maximum, which indicates that Et was greatly influenced by heterogeneity of indicator transit times through the intervillous space. The ascending part of the plot of -1n(I-Et) against time (t) of 86Rb was approximately linear. In each experiment the time corresponding to zero extraction was estimated by linear extrapolation of the plot. The mean of the times obtained in the individual experiments corresponded to the most frequent transit time of the indicators through the system outside the placenta. These observations suggest that 86Rb is taken up by the trophoblast from the entire space perfused. Under such conditions the rate of the trophoblast uptake can be estimated from the slope of the above plot. Unlike that of 86Rb, Et of [14C]D-glucose increased rapidly to a relatively steady level. This time course of Et may result from combined effects of transit time heterogeneity and rapid back-flux of the tracer.

[Development of pregnancy in genetic risk patients with special reference to transabdominal amniocentesis]. / Die Entwicklung der Schwangerschaft bei genetischen Risikopatientinnen unter besonderer Berücksichtigung der transabdominalen Amniozentese.

A complex 3-stage-method of pregnancy evaluation in genetic patients with a planned-transabdominal amniocentesis reduces essentially the risk of the intervention; the state of maternal organism, placental function and fetal growth are repeatedly assessed. Fetal growth retardation together with poor placental function indicated in 4 cases a malformation of the type not be able to be diagnosed cytogeneticylla. Our experience is derived from 404 pregnancies followed before and after transabdominal amniocentesis.