Scapula length measurement for assessment of fetal growth and development.

To determine the value of prenatal ultrasonographic scapula measurements for fetal growth and development as an adjunct to assessing in utero development, a prospective study of ultrasonography was conducted in 343 pregnant women with uneventful pregnancies with gestational ages from 16 to 41 weeks, and several biometric measurements were obtained. The relationships of scapula length with gestational age and with biparietal diameter, femur length, abdominal circumference and scapula length were examined. With the ultrasonographic examinations of 343 healthy pregnant women, a nomogram of scapula length measurements estimating gestational age and predicting the biparietal diameter, abdominal circumference, and femur length was generated. Linear relationships were found between the scapula length and the gestational age (R2 = 0.94, p < 0.0001), the biparietal diameter (R2 = 0.94, p < 0.0001), abdominal circumference (R2 = 0.94, p < 0.0001), and the femur length (R2 = 0.95, p < 0.0001). The rate of increase of scapula length was significantly higher before 28 weeks of gestation than in later pregnancy (p < 0.0001). The correlation coefficients between gestational age and scapula length were 0.95 before 28 weeks of gestation and 0.86 in later weeks. These results suggest that scapula length measurement is a valuable parameter for the assessment of fetal growth and development.

Benign cystic teratoma of the douglas.

We report a case of a benign cystic teratoma in a 30-year-old woman who underwent laparoscopy for a persisting pelvic mass in the posterior cul-de-sac. Our review of the literature indicates that, this is the second teratoma case of the douglas and the first one removed laparoscopically.

Epidermoid cyst of the cecum.

An epidermoid cyst of the cecum is reported in an 8-year-old girl who presented with vague abdominal pain. Abdominal ultrasound scan showed a mass that was cystic in nature. During operation, a subserosal cystic mass was found in the wall of the cecum and confirmed to be an epidermoid cyst histopathologically. This is the first case of epidermoid cyst of the cecum in children reported in the literature.

Growth of the fetal lens and orbit.

OBJECTIVES: To present normal lens and orbital measurement ranges by gestational age. METHODS: Three hundred and thirty-five women with uneventful pregnancies were evaluated from the 15th to the 40th week of gestation. Lens and orbital measurements were added to routine biometric measurements for normal fetuses. RESULTS: A strong linear correlation was observed between gestational age (GA) and lens diameter (R(2)=0.89; P<0.0001), circumference (R(2)=0.89; P<0.0001), and surface (R(2)=0.90; P<0.0001). A linear correlation was also found between GA and orbital diameter (R(2)=0.92; P<0.0001), circumference (R(2)=0.92; P<0.0001) and surface (R(2)=0.95; P<0.0001). A linear growth function was observed between biparietal diameter and both lens diameter (R(2)=0.90; P<0.0001) and orbital diameter (R(2)=0.94; P<0.0001). CONCLUSION: Lens and orbital measurements provide normative data for fetal growth and development. These data may be also helpful in detecting fetal ocular anomalies.

Does hepatic subcapsular calcification in a premature baby reflect disease?

We followed a premature baby with hepatic subcapsular calcification of unknown etiology. Results of clinical and laboratory investigations and growth of the patient were normal. The causes of this condition are discussed and we suggest that it does not necessarily reflect disease.

An unusual cause of renal colic: hydatiduria.

Hydatid disease of the urinary tract is seen rarely. Hydatiduria may be a finding of renal involvement, but it is a rare cause of renal colic. A case is reported of renal hydatid disease that was diagnosed during the investigation of renal colic. A 38-year-old woman presented with renal colic. She had a history of episodes of renal colic and occasional voiding of grape-like material. No calculus was found in the urinary tract by plain film or ultrasonographic examination. The histopathologic examination of this material revealed daughter cysts that are pathognomonic for hydatid disease. Ultrasound and computed tomography confirmed this diagnosis and right nephrectomy was performed without cyst perforation or any spilling of cyst content. Albendazole, 10 mg/kg per day, was given for 4 weeks (2 weeks preoperatively and 2 weeks postoperatively).

Umbilical artery blood flow characteristics in normal pregnancies.

585 pregnant women were investigated with both conventional sonographic examination and color Doppler examination. The cases with intrauterine growth retardation, preeclampsia, twin pregnancies, congenital malformations and diabetes were excluded. The remaining 550 cases (between ages 16 and 40) were investigated in the first trimester and gestational ages were compatible with the last menstrual date. In order to evaluate fetal development, biparietal diameter, femur length, abdominal circumference, and estimated fetal weight were calculated by conventional ultrasonographic method. The application of Doppler ultrasound to the study of fetal umbilical arterial blood flow velocity is a relatively new technique. The failure to obtain useful Doppler signals was about 18-22% with pulse-wave Doppler system. Recently, color Doppler technology solved this problem. We used an ALOKA 680-SSD ultrasonography device and color Doppler ultrasonography technique and recorded umbilical arterial Doppler signals from every case and calculated classical Doppler indices--systolic/diastolic (S/D) ratio, pulsatility index (PI), Pourcelot index or resistive index (RI). Statistical comparisons were made by SPSS program. Correlation coefficient and R2 values between gestational age and other indices were calculated. The aforementioned values were r:-0.79; R2:0.63 0.63; r:-0.71; R2:0.50, r:-0.64; R2:0.41, for S/D, PI, RI, respectively.

Fetal methemoglobinemia: a cause of nonimmune hydrops fetalis.

A case of nonimmune hydrops fetalis resulting from fetal methemoglobinemia is presented. A woman with a pregnancy at 17 weeks' gestation was admitted after combustion gas intoxication. Although the mother totally recovered, the fetus showed signs of nonimmune hydrops fetalis at follow-up. Fetal methemoglobin levels were very high.

Transverse cerebellar diameter and transverse cerebellar diameter/ abdominal circumference index for assessing fetal growth.

In a prospective study of 330 pregnant women, measurements of the transverse cerebellar diameter (TCD), abdominal circumference (AC), biparietal diameter (BPD), head circumference (HC) and TCD/AC ratio and HC/AC ratio were obtained using conventional ultrasonography between 16th and 41st weeks of gestation. Measurement of BPD yielded a strong correlation with gestational age (r = 0.9880 and R2 = 0.9761) by cubic regression analysis. The measurement of TCD also had a very close relation with gestational age (r = 0.9767 and R2 = 0.9539). The ratio between TCD and AC was calculated and found to be 0.1436 +/- 0.0106 (SD) which remained fairly constant throughout pregnancy, while the BPD/AC ratio declined. The 5th and 95th percentiles for this ratio were 0.1279 and 0.1603. Ten of eleven fetuses with TCD/AC ratios exceeding 2 SD (0.1648) were found to have asymmetrical intrauterine growth retardation upon neonatal examination. It is demonstrated that both BPD and TCD measurements are reliable techniques that correlate well with gestational age, and the TCD/AC ratio is valuable in identifying babies with asymmetrical intrauterine growth retardation.

The predictive power of endocrine tests for the diagnosis of polycystic ovaries in women with oligoamenorrhea.

Various hormonal parameters and the best logistic regression model to predict disease probability were evaluated in women with polycystic ovary syndrome (PCOS). Concentrations of LH, FSH, LH/FSH ratio, testosterone, free testosterone, SHBG and insulin in serum were recorded in 32 women with PCOS and in 25 controls. A model including LH/FSH ratio, insulin and testosterone measurements yielded the best goodness of fit for classification of women with and without PCOS in the logistic regression analysis. Only LH/FSH ratio and insulin were retained as significant variables. The diagnostic characteristics of LH/FSH ratio and insulin for PCOS when compared by receiver-operator characteristic analysis were found to be equally effective. By combining these two variables a higher area under curve was obtained. LH/FSH ratio, insulin or the combination of these two can predict the disease probability in women with PCOS.