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1.
Ultrasound Obstet Gynecol ; 52(6): 715-721, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29027723

RESUMO

OBJECTIVE: To determine the frequency and nature of copy number variants (CNVs) identified by chromosomal microarray analysis (CMA) in a large cohort of fetuses with isolated increased nuchal translucency thickness (NT) ≥ 3.5 mm. METHODS: This was a retrospective, multicenter study, including 11 French hospitals, of data from the period between April 2012 and December 2015. In total, 720 fetuses were analyzed by rapid aneuploidy test and the fetuses identified as euploid underwent CMA. CNVs detected were evaluated for clinical significance and classified into five groups: pathogenic CNVs; benign CNVs; CNVs predisposing to neurodevelopmental disorders; variants of uncertain significance (VOUS); and CNVs not related to the phenotype (i.e. incidental findings). RESULTS: In 121 (16.8%) fetuses, an aneuploidy involving chromosome 13, 18 or 21 was detected by rapid aneuploidy test and the remaining 599 fetuses were euploid. Among these, 53 (8.8%) had a CNV detected by CMA: 16/599 (2.7%) were considered to be pathogenic, including 11/599 (1.8%) that were cryptic (not visible by karyotyping); 7/599 (1.2%) were CNVs predisposing to neurodevelopmental disorders; and 8/599 (1.3%) were VOUS. Additionally, there was one (0.2%) CNV that was unrelated to the reason for referral diagnosis (i.e. an incidental finding) and the remaining 21 were benign CNVs, without clinical consequence. Interestingly, we identified five genomic imbalances of the 1q21.1 or 15q11.2 regions known to be associated with congenital heart defects. CONCLUSION: Our study demonstrates the benefit of CMA in the etiological diagnosis of fetuses with isolated increased NT. It is worth noting that most (69%) of the detected pathogenic CNVs were cryptic. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Aberrações Cromossômicas , Variações do Número de Cópias de DNA , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Diagnóstico Pré-Natal/métodos , Adolescente , Adulto , Aneuploidia , Cromossomos Humanos/genética , Feminino , Idade Gestacional , Humanos , Idade Materna , Medição da Translucência Nucal , Gravidez , Estudos Retrospectivos , Adulto Jovem
3.
Eur J Med Genet ; 66(7): 104769, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37121269

RESUMO

Signs of skeletal dysplasias are relatively common in fetuses with abnormal ultrasound (US) findings. The diversity of congenital skeletal disorders, the possibility of late-onset severe phenotypes and overlapping syndromes can be a challenge in the way of diagnosis, even if prenatal high-throuput sequencing allows for a better diagnosis, prognosis and genetic counseling. Hajdu-Cheney spectrum pathologies are rarely described in prenatal, and the signs associated remain poorly known, and do not include specific postnatal signs as acro-osteolysis and premature osteoporosis. We hereby report a couple for whom a medical termination of pregnancy was performed because a severe polymalformative syndrome associating severely short limbs with bowed long bones, severe cardiopathy, hyperechogenic kidneys and dysmorphism. After fetopathological and radiological examinations, Exome Sequencing (ES) was performed and revealed a de novo truncating mutation in the last exon of NOTCH2, responsible for Hajdu-Cheney or Serpentine Fibula Polycystic Kidney syndromes.


Assuntos
Acro-Osteólise , Síndrome de Hajdu-Cheney , Osteoporose , Feminino , Humanos , Gravidez , Síndrome de Hajdu-Cheney/diagnóstico por imagem , Síndrome de Hajdu-Cheney/genética , Osteoporose/genética , Acro-Osteólise/genética , Éxons , Apresentação no Trabalho de Parto , Receptor Notch2/genética
4.
Fetal Diagn Ther ; 30(3): 239-40, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21934288

RESUMO

Cloacal anomaly is a rare malformation with an incidence of 1 in 50,000 births. The definitive prenatal diagnosis of cloacal dysgenesis sequence is difficult. The use of three-dimensional (3-D) ultrasonography helps to describe the perineum and change diagnosis. In our case report, a large median genital structure was visualized, which was initially considered a penis-like structure, but the 3-D technique showed an enlarged bud. The urethral meatus was at the tip of this smooth structure. The lack of anal structure was clearly demonstrated.


Assuntos
Cloaca/anormalidades , Cloaca/diagnóstico por imagem , Doenças Fetais/diagnóstico por imagem , Imageamento Tridimensional , Ultrassonografia Pré-Natal/métodos , Adolescente , Cloaca/embriologia , Feminino , Humanos , Recém-Nascido , Gravidez
6.
Gynecol Obstet Fertil ; 36(4): 407-12, 2008 Apr.
Artigo em Francês | MEDLINE | ID: mdl-18417406

RESUMO

Bronchial atresia is a rare congenital malformation of the lung. The main-stem segmental or lobar bronchus fails to construct normally, which can lead to accumulation of mucus within the distal bronchi or lung hyperinflation of the obstructed lobe. The prenatal diagnosis is rare and difficult. We report two cases of fetuses who presented pathological examination of the lung on the ultrasonography, at 22 weeks of gestation, suspect of prenatal bronchial atresia diagnosis. We analysed this malformation through a literature review in order to discuss differential diagnosis to be evoked, as well as appropriate perinatal management.


Assuntos
Brônquios/anormalidades , Diagnóstico Pré-Natal/métodos , Anormalidades do Sistema Respiratório/diagnóstico , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da Gravidez , Anormalidades do Sistema Respiratório/diagnóstico por imagem
7.
J Gynecol Obstet Biol Reprod (Paris) ; 36(8): 777-85, 2007 Dec.
Artigo em Francês | MEDLINE | ID: mdl-17616263

RESUMO

Three cases of intermittent absent end-diastolic and reversed end-diastolic flow velocity (A/REDV) are reported in the proximal umbilical artery of the growth-retarded twin in monochorionic twin pregnancies. This typical doppler velocimetric pattern has been related to arterio-arterial anastomoses in two cases of intra-uterine growth retardation and in one case of twin-twin transfusion syndrome. According to the literature, superficial arterio-arterial anastomoses may be detected by doppler colour velocimetry in 75 to 85% of cases, while identification of arteriovenous connections is more difficult to be documented in vivo (50% of cases in experienced hands). The role of superficial vascular anastomoses, either arterio-arterial or venovenous, and that of deep arteriovenous communications is now well documented in the main complications of monochorionic pregnancies, particularly for twin-twin transfusion syndrome, intrauterine growth retardation, intrauterine fetal death and acardiac twins.


Assuntos
Doenças em Gêmeos/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Gêmeos Monozigóticos , Ultrassonografia Doppler em Cores , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem , Adulto , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Transfusão Feto-Fetal/diagnóstico por imagem , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Gravidez Múltipla
8.
J Gynecol Obstet Biol Reprod (Paris) ; 35(4): 396-404, 2006 Jun.
Artigo em Francês | MEDLINE | ID: mdl-16940908

RESUMO

We report the cases of two patients who had a favorable outcome with aspirin and corticosteroid therapy during pregnancy for chronic villitis of unknown etiology complicated by labor asphyxia and further intrauterine fetal demise in one gravida 3 patient and for chronic intervillositis of unknown etiology diagnosed after three perinatal deaths in another patient (gravida 4). Chronic villitis of unknown etiology (CVUE) is detected in 7 to 33% of placentas, mainly after intrauterine growth retardation (IUGR), unexplained prematurity, preeclampsia, perinatal asphyxia and intrauterine fetal death (IUFD). The less frequent chronic intervillositis of unknown etiology (CIUE) (0.6 to 0.9/1.000) has been implicated in recurrent severe pregnancy complications, such as spontaneous abortions, IUGR and IUFD. Histopathology and immunohistology are in favor of an immune response against the foreign fetal allograft. The favorable results obtained with corticosteroids and aspirin remain to be confirmed by larger series.


Assuntos
Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Vilosidades Coriônicas , Doenças Placentárias/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Adulto , Vilosidades Coriônicas/imunologia , Vilosidades Coriônicas/patologia , Quimioterapia Combinada , Feminino , Retardo do Crescimento Fetal/etiologia , Humanos , Imuno-Histoquímica , Recém-Nascido , Inflamação/complicações , Inflamação/imunologia , Inflamação/prevenção & controle , Masculino , Doenças Placentárias/imunologia , Doenças Placentárias/prevenção & controle , Gravidez , Complicações na Gravidez/imunologia , Complicações na Gravidez/prevenção & controle , Resultado da Gravidez , Prevenção Secundária
9.
Gynecol Obstet Fertil ; 44(10): 572-577, 2016 Oct.
Artigo em Francês | MEDLINE | ID: mdl-27318772

RESUMO

OBJECTIVE: The aim of this study is to propose an analysis of the route and the curvature of the Essure® system in 3D ultrasound to determine their correct location so as not to miss a tubal perforation. METHODS: This is a retrospective single center study during 2 years analyzing 92 3D ultrasound performed by a single sonographer. Implant placement was performed by different operators. One prescribed 3D ultrasound control in case of difficulties with the installation; other indications where systematics. RESULTS: The Essure®'s position is right in 79% of cases. Twenty-eight implants appear incorrectly positioned on ultrasound 3D positioning. Abnormalities found are those described by the classification proposed in the literature. In one case, the curvature of the implant, not taking into account this classification, allowed to evoke a tubal perforation. Among the 28 cases of non-visualized implants in place, 3 cases of wrong position of the implant were confirmed by additional examinations (laparoscopy or HSG). For 14 cases, the ASP or HSG disproved the wrong position of the implants. In other cases, we did not have other complementary examinations. CONCLUSION: Ultrasonography 3D seems to be the method of choice to control implants for simple implementation and good reproducibility. However, the interpretation of 3D ultrasound images is sometimes difficult. The study of the curvature of the implant should be systematically analyzed not to miss a tubal perforation.


Assuntos
Tubas Uterinas/diagnóstico por imagem , Imageamento Tridimensional/métodos , Esterilização Tubária/instrumentação , Esterilização Tubária/métodos , Ultrassonografia/métodos , Adulto , Tubas Uterinas/lesões , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
10.
Gynecol Obstet Fertil ; 43(12): 767-72, 2015 Dec.
Artigo em Francês | MEDLINE | ID: mdl-26584892

RESUMO

OBJECTIVES: Anomalies of the maxillofacial development concern 1 for 700 births. About 30% of prenatal diagnoses of isolated primary cleft palate or associated with a cleft of secondary palate will be corrected in postnatal. This retrospective observational study was designed to compare the antenatal data and postnatal diagnosis regarding a series of clefts. MATERIALS AND METHODS: All children born between 1 December 2009 and 31 January 2014 in a prenatal diagnostic reference center and having a cleft palate were included. Newborns with an abnormality associated with the cleft were excluded. A comparison was made between the data in the antenatal ultrasound reports and postnatal those described by the surgeon during surgery. RESULTS: Forty-four children were included and three infants were excluded due to associated anomalies. Of those 41 children, 27 children have been screened. Ultrasound and clinical diagnosis was the same for 23 cases (85.2%) and inaccurate for 4 patients (14.8%). In case of primary cleft palate prenatal diagnosis was performed to 19 cases of 21 (90.5%), but only 8 of 20 if only secondary cleft palate (42.1%) including 7 with a Pierre-Robin sequence. DISCUSSION: Antenatal screening sensitivity of primary and secondary cleft palate increase in recent years with a rate of 85.2% in our series. By contrast, diagnosis of isolated secondary cleft palate seems to be more difficult and 3D ultrasound does not always improve screening performance. CONCLUSION: Ultrasound 2D seem sufficient for screening of primary and secondary cleft palate. The 3D ultrasound may be useful for a better representation of the cleft for future parents. The same language concerning the classification of the clefts facilitates harmonization of reporting and understanding between professionals. The presence of the maxillofacial surgeon ultrasound room would allow the sonographer to direct its ultrasound accurately or improve its learning curve.


Assuntos
Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Ultrassonografia Pré-Natal , Fenda Labial/embriologia , Fenda Labial/cirurgia , Fissura Palatina/embriologia , Fissura Palatina/cirurgia , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia Pré-Natal/métodos
11.
Gynecol Obstet Fertil ; 43(11): 705-11, 2015 Nov.
Artigo em Francês | MEDLINE | ID: mdl-26542939

RESUMO

OBJECTIVES: Beckwith-Wiedemann syndrome (BWS) is the most common overgrowth syndrome and has an incidence of 1/13,700. The majority of the cases are diagnosed after birth. Patients with BWS have an increased risk of neonatal hypoglycemia and embryonal tumors development in childhood. We wanted to identify the ultrasound signs that must alert physicians to prepare best perinatal management strategies. METHODS: We conducted a retrospective study of a population of 14 cases of BWS diagnosed in perinatal period; four of them were detected prenatally by ultrasound. The anomalies signs described in prenatal were analyzed and compared with the clinical features of the postnatal period. RESULTS: The major features reported were represented by macrosomia for 71.4% with an increase of abdominal circumference, and macroglossia for 78.6%. The minor features were various with 64% of visceromegaly (nephromegaly and/or hepatomegaly), 50% of hydramnios and for 80% of male children a genital anomaly (crytorchidism and/or hypospadias). CONCLUSION: This study identified some prenatal ultrasound signs that should alert the clinician to the possibility of BWS. A genetic conseling, after confirmation by molecular diagnosis, could be proposed in a near future in prenatal, and could improve postnatal management strategies for these affected children at high postnatal risk.


Assuntos
Síndrome de Beckwith-Wiedemann/diagnóstico por imagem , Ultrassonografia Pré-Natal , Síndrome de Beckwith-Wiedemann/complicações , Criptorquidismo/diagnóstico por imagem , Feminino , Doenças Fetais/diagnóstico por imagem , Macrossomia Fetal/diagnóstico por imagem , Humanos , Hipoglicemia/etiologia , Hipospadia/diagnóstico por imagem , Recém-Nascido , Macroglossia/congênito , Macroglossia/diagnóstico por imagem , Masculino , Poli-Hidrâmnios , Gravidez , Diagnóstico Pré-Natal , Estudos Retrospectivos
12.
J Perinatol ; 24(11): 733-4, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15510104

RESUMO

The clinical features of Prader-Willi Syndrome (PWS) in the neonate are marked by hypotonia, absence of crying, and feeding difficulties, but the clinical nature of PWS in utero remains unclear. We report a case of PWS with fetal immobility and distal arthrogryposis in a girl admitted the first day of life to the neonatal intensive care unit for severe hypotonia and respiratory distress.


Assuntos
Artrogripose/complicações , Hipotonia Muscular/complicações , Síndrome de Prader-Willi/diagnóstico , Feminino , Humanos , Recém-Nascido , Síndrome de Prader-Willi/complicações
13.
J Gynecol Obstet Biol Reprod (Paris) ; 32(4): 368-74, 2003 Jun.
Artigo em Francês | MEDLINE | ID: mdl-12843886

RESUMO

Hyperreactio luteinalis (HRL) is rarely observed in normal pregnancy. Its clinical spectrum consists of benign development of often bilateral lutein cysts and may be revealed by an overproduction of androgens. HRL is more often in relation with an excessive production of human chorionic gonadotropin (hCG) either in trophoblastic disease or in hyperplacentosis (Rh-alloimmunization or diabetes), but in 60% of the cases HRL may occur in normal singleton pregnancies. Many benign or malignant ovarian lesions can mimic HRL during pregnancy. The pathophysiology of HRL in singleton pregnancies involves an increased sensitivity of ovarian stromal cells to hCG. A positive ovarian stimulation test with hCG, recommended three months after delivery may detect a recurrence risk for further pregnancies. Conservative treatment is advised and surgery must be reserved for maternal complications.


Assuntos
Luteinização , Cistos Ovarianos/diagnóstico , Ovário/patologia , Complicações na Gravidez/diagnóstico , Adulto , Androgênios/fisiologia , Gonadotropina Coriônica/fisiologia , Diagnóstico Diferencial , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hiperplasia , Recém-Nascido , Hormônio Luteinizante/sangue , Masculino , Cistos Ovarianos/sangue , Cistos Ovarianos/etiologia , Indução da Ovulação , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/etiologia , Gravidez em Diabéticas/complicações , Recidiva , Isoimunização Rh/complicações , Fatores de Risco , Tumor Trofoblástico de Localização Placentária/complicações , Ultrassonografia Pré-Natal
14.
J Gynecol Obstet Biol Reprod (Paris) ; 33(2): 131-9, 2004 Apr.
Artigo em Francês | MEDLINE | ID: mdl-15052179

RESUMO

We report a case of a pregnant woman with a mitochondrial disorder affecting the energy-generating pathway of oxidative phosphorylation which was suggested when the patient presented the progressive clinical phenotype of a proximal tubular renal insufficiency, a muscular weakness of extremities, a bilateral optic neuropathy and a brain magnetic resonance imaging suggesting diffuse leucoencephalopathy. Her diagnosis was made on the basis of abnormal mitochondria on a muscle biopsy and of spectrophotometric deficiencies of the complexes I, II+III and IV of the respiratory chain. No specific molecular mutation could be detected. Her pregnancy was complicated by a severe preeclampsia, an insulin requiring gestational diabetes and a worrying renal failure which precipitated the premature delivery by cesarean section at 30 weeks gestation. The clinical course of the female neonate weighing 1030 grams was uneventful. At two Years of age she showed no sign of mitochondrial disease. But the postpartum course of the mother was complicated by seizures and a terminal renal failure leading presently to dialysis, but requiring a kidney transplantation in the near future.


Assuntos
Falência Renal Crônica/etiologia , Doenças Mitocondriais/complicações , Complicações na Gravidez , Resultado da Gravidez , Transtornos Puerperais/etiologia , Adulto , Cesárea , Diabetes Gestacional , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Falência Renal Crônica/terapia , Pré-Eclâmpsia/complicações , Gravidez , Transtornos Puerperais/terapia , Diálise Renal , Convulsões/etiologia
15.
J Gynecol Obstet Biol Reprod (Paris) ; 31(8): 783-5, 2002 Dec.
Artigo em Francês | MEDLINE | ID: mdl-12592200

RESUMO

A case of spontaneous rectus sheath hematoma is reported in a 32-year-old multigravida transferred to our antepartum unit for premature labor and persistent cough related to Candida dubliniensis upper airway infection. In pregnant patients presenting sudden-onset severe abdominal pain and parietal tenderness, there are two main differential diagnoses: abruptio placentae and aseptic necrobiosis of a uterine leiomyoma. The correct diagnosis may be obtained by ultrasonography and sometimes by computed tomography. In the present case an emergency cesarean section was performed at 35 weeks gestation after a 40% decrease in maternal hemoglobin and onset of fetal heart rate anomalies.


Assuntos
Hematoma/diagnóstico por imagem , Doenças Musculares/diagnóstico por imagem , Complicações Hematológicas na Gravidez/diagnóstico por imagem , Reto do Abdome/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Hematoma/cirurgia , Humanos , Doenças Musculares/cirurgia , Gravidez , Complicações Hematológicas na Gravidez/cirurgia , Reto do Abdome/irrigação sanguínea , Reto do Abdome/cirurgia , Resultado do Tratamento , Ultrassonografia Pré-Natal
16.
Gynecol Obstet Fertil ; 42(6): 438-40, 2014 Jun.
Artigo em Francês | MEDLINE | ID: mdl-24411294

RESUMO

Epidermolysis bullosa (EB) comprises a heterogeneous group of genodermatoses whose prognosis is variable. The diagnosis is suggested by prenatal ultrasound at signs, especially for junctional EB with pyloric atresia. The authors report a case of antenatal image limited skin undermining highlighted by the ultrasound three-dimensional (3D) in connection with a diagnosis of a congenital epidermolysis simplex confirmed postnatal period.


Assuntos
Epidermólise Bolhosa Simples/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Epidermólise Bolhosa Simples/patologia , Feminino , Humanos , Recém-Nascido , Gravidez , Injeções de Esperma Intracitoplásmicas , Ultrassonografia Pré-Natal/métodos
17.
Gynecol Obstet Fertil ; 42(7-8): 533-6, 2014.
Artigo em Francês | MEDLINE | ID: mdl-24934770

RESUMO

Bilateral pulmonary agenesis (BPA) is a rare congenital lung malformation. The prognosis is severe as it is incompatible with extra-uterine life. Although multiple prenatal imaging modalities are developed, the prenatal diagnosis of BPA remains problematic. We report a case of BPA observed in our unity and for which the diagnosis was not clearly identified during the evaluation. This report illustrates the need to consider all the imaging aspects and particularly during US examination suspecting BPA.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pulmão/anormalidades , Diagnóstico Pré-Natal/métodos , Ultrassonografia Pré-Natal , Anormalidades Múltiplas/embriologia , Amniocentese , Feminino , Idade Gestacional , Humanos , Cariotipagem , Pulmão/diagnóstico por imagem , Pulmão/embriologia , Pneumopatias/embriologia , Imageamento por Ressonância Magnética , Gravidez , Prognóstico
18.
Gynecol Obstet Fertil ; 42(4): 254-7, 2014 Apr.
Artigo em Francês | MEDLINE | ID: mdl-24394322

RESUMO

The paternal uniparental disomy 14 is a rare malformation syndrome whose postnatal pathognomonic sign is the deformation of the rib as coat hanger. In prenatal, ultrasonographic signs are major recurrent polyhydramnios, a narrow thorax and deformed long bones short and sometimes other anomalies including ends. The authors report one rare case of prenatal paternal uniparental disomy 14 with the deformation of the rib as coat hanger. Prenatally, the narrow deformed thorax can be searched by ultrasound three-dimensional (3D) and/or helical CT and thus represent an aid to prenatal diagnosis.


Assuntos
Ultrassonografia Pré-Natal , Cromossomos Humanos Par 14/diagnóstico por imagem , Feminino , Humanos , Recém-Nascido , Poli-Hidrâmnios/genética , Gravidez , Costelas/anormalidades , Tórax/anormalidades , Tomografia Computadorizada Espiral , Dissomia Uniparental/fisiopatologia , Adulto Jovem
20.
Artigo em Francês | MEDLINE | ID: mdl-22819253

RESUMO

We report a rare case of Tessier no. 4 craniofacial cleft diagnosed by ultrasound imaging at 10 weeks' gestation. Tessier no. 4 craniofacial cleft is a very rare and complex congenital abnormality, characterized by an oblique orbitomaxillary facial cleft. Prenatal diagnosis of orofacial clefting is usually done at midtrimester of pregnancy, based on careful sonographic examination of the fetal face. However conventional 2D ultrasound is limited in screening isolated cleft palate and defects of the secondary palate. Thus, 3D ultrasound shows a greater sensitivity in a referred population and antenatal evaluation of facial clefs.


Assuntos
Coloboma/diagnóstico por imagem , Anormalidades Craniofaciais/diagnóstico por imagem , Órbita/anormalidades , Ultrassonografia Pré-Natal , Coloboma/complicações , Anormalidades Craniofaciais/complicações , Face , Feminino , Humanos , Imageamento Tridimensional/estatística & dados numéricos , Lábio/anormalidades , Órbita/diagnóstico por imagem , Gravidez , Primeiro Trimestre da Gravidez/fisiologia , Adulto Jovem
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