Neutrophil gelatinase-associated lipocalin serum evaluation through normal pregnancy and in pregnancies complicated by preeclampsia.

Neutrophil gelatinase-associated lipocalin (NGAL) was evaluated prospectively through normal pregnancy and pregnancies complicated by preeclampsia syndrome. Sixty women enrolled in the study were evaluated for serum NGAL levels at 9-11 weeks gestation, at 24-26 weeks gestation and at delivery. Thirty women were affected by preeclampsia and 30 women with uncomplicated pregnancies formed the control group. NGAL serum concentrations in the preeclampsia group were higher compared to the control group, with significant differences in each trimester. In the first trimester, the median values were: 29.9 ng/mL [interquartile range (IQR) 24.1-50.1] versus 13.6 ng/mL (IQR 9.1-19.9; p < 0.001); in the second trimester: 59.6 ng/mL (IQR 25.3-82.6) versus 16.3 ng/mL (IQR 11.3-23.3; p < 0.001); and in the third trimester: 57.2 ng/mL (IQR 18.7-70.9) versus 15.8 ng/mL (IQR 9.1-22.5; p < 0.001). NGAL serum values were positively correlated with systolic and diastolic blood pressure and with proteinuria.

Prenatal diagnosis of limb abnormalities: role of fetal ultrasonography.

Fetal ultrasonografy is the most important tool to provide prenatal diagnosis of fetal anomalies. The detection of limb abnormalities may be a complex problem if the correct diagnostic approch is not established. A careful description of the abnormality using the rigth nomenclature is the first step. Looking for other associated abnormalities is the threshold to suspect chromosomal abnormalities or single gene disorder. According to the patogenic point of view, limb abnormalities may be the result of malformation, deformation, or disruption. The prenatal diagnosis and the management of limb abnormalities involve a multidisciplinary team of ostetrician, radiologist/sonologist, clinical geneticist, neonatologist, and orthopedic surgeons to provide the parents with the information regarding etiology of the disorder, prognosis, option related to the pregnancy and recurrence risk for future pregnancies.The aim of this review is to describe the importance of detailed fetal ultrasonography in prenatal diagnosis of limb abnormalities.

Fetal intracranial cysts: prenatal diagnosis and outcome.

Intracranial cysts are central nervous system malformations involving different brain regions, and commonly diagnosed during prenatal period by ultrasound scan (US). A malformative cyst is a nontumoral fluid-filled collection exerting a mass effect on the brain parenchyma and/or on the ventricles, regardless of its location within subarachnoid spaces, brain or ventricles, and of the nature of its limiting membrane, which is always unknown prenatally. Although a large number of case reports have been published, many uncertainties remain concerning their epidemiology, pathogenesis, and outcome. Most of these lesions, if not associated with other fetal anomalies, are benign in nature, remain clinically silent, do not evolve or even frequently regress spontaneously and do not impair physiologic neurodevelopment. The normality of the adjacent brain is the major argument in favour of a malformative lesion. The correct diagnosis is of crucial importance to exclude the presence of other rare lesions (e.g. cystic neoplasms or intracranial hemorrhage) that could negatively affect neurodevelopmental outcome of the child. To establish a correct prognosis all efforts must aim to precisely interpret the US images accurately analyzing the brain anatomy.

Ultrasound Scanning in Fetal Renal Pelvis Dilatation: not only Hydronephrosis.

Pelvic dilatation is the alteration of the urinary tractmost frequently detected by maternal-fetalultra-sound. Hydronephrosis is not a diagnosis; it is an imagefinding. The diagnosis is the cause that produces it. Since pelvic dilatation is relatively frequent in thenormal fetus, and the definition and diagnosis of hy-dronephrosis are difficult, once it is detected, adequate follow-up is required. Therefore, it is important for the urologist and obstetrician to understanddifferential diagnosis and clinical implications in order to offer an accurate counselling to the parents.

Obstetric management in Rh alloimmunizated pregnancy.

Rh alloimmunization occurs when maternal immune system is sensitized to D(Rh) erythrocyte surface antigens.The most common causes of maternal Rh alloimmunisation are blood transfusion and antepartum or intrapartum fetomaternal hemorrhage (abdominal trauma, abortion, ectopic pregnancy, invasive obstetric procedures, placental abruption, external cephalic version).The risk of alloimmunization is affected by several factors, including the degree of fetomaternal hemorrhage and maternal immune respons.Although the introduction of anti D prophylaxis reduced dramatically the rate of alloimmunization in susceptible women, his prevention is not universal and about 0.3% of susceptible women still become Rh D alloimmunized.The aim of this article is to review the management of the Rh alloimmunizated pregnant.

Abnormal skull findings in neural tube defects.

The human neural tube develops and closes during the third and fourth week after conception and is normally completed by 28 days post-conception. Malformations, knows as neural tube defects, occure, when the normal closure process fails. Several clinical types of neural tube defects are recognized, anencefaly and spina bifida being the most common. Such malformations are generally associated with cranial abnormlities.