[Apert syndrome. Ultrasonic diagnosis, obstetrical management]. / Syndrome d'Apert. Diagnostic échographique, prise en charge obstétricale.

We report two observations of antenatal diagnosis of Apert syndrome. This uncommon genetic disorder suggest an autosomal dominant inheritance, but almost all cases described are sporadic; the responsible gene is yet not located. Ultrasonographic detection is difficult, based on the following signs: brachycephalic skull (unusually detected), flat facial profile with a nasal bridge depression, tall appearance of the forehead (inconstant), total bilateral and symmetrical syndactylies of the hands and feet. At last we present our arguments for medical abortion, when this disorder is detected.

[Hydrops fetalis of non-immunological origin. Study of 24 cases and review of the literature]. / Anasarques foetoplacentaires d'origine non immunologique. Etude de 24 cas et revue de la littérature.

Twenty-four cases of Schriddes' disease of non-immunological origin were observed between 1973 and 1990 in the Gynecology-Obstetrics Service at Angers (France). These cases are analyzed and the results are compared with those published in the literature. This disorder must be diagnosed before birth. Three examinations are currently essential for foetal assessment: obstetrical ultrasound, ultrasonic cardiography and amniocentesis. As a result of improved antenatal diagnosis, the question of the indications for in-utero treatment and medical termination of pregnancy now arises. Despite progress in neonatal resuscitation, the prognosis generally remains very poor.

[Antenatal prognostic factors in sacrococcygeal teratomas]. / Facteurs pronostiques anténatals des tératomes sacro-coccygiens.

The authors report 5 cases of sacrococcygeal teratoma, 4 of which were diagnosed by routine ultrasonography. In view of the poor prognosis of sacrococcygeal teratomas discovered antenatally, certain ultrasonographic severity criteria have been defined. The following are felt to be relevant in this light of present knowledge: a tumour size greater than the biparietal diameter of the fetus at the time of diagnosis; rapid tumour growth. This latter parameter summarises in itself the criteria taken into account in the past: placentomegaly, hydramnios, anasarca. Colour coded Doppler should make it possible in the future to identify a group which might benefit from treatment in utero.

[Cervical pregnancy. Contribution of ultrasonography to diagnosis and therapeutic management]. / La grossesse cervicale. Apport de l'échographie au diagnostic et à la prise en charge thérapeutique.

Three recent cases of cervical pregnancy form the basis of a review of its principal clinical and ultrasonographic characteristics and their resultant management consequences. Ultrasonography enables better diagnosis and management, leading to the preservation of subsequent fertility.