Sonographic findings in partial type of trisomy 18

Trisomy 18 [Edwards syndrome] is the second most common trisomy among live born fetuses, with poor prognosis. Estimate of its incidence is between 1 in 4000- 16000 live births. Most of the chromosomal abnormalities in fetuses are detected by prenatal ultrasound findings in the first and second trimesters. In this case report, we present a partial type of trisomy 18 occurring through de novo unbalanced translocation of chromosomes 18 and 21. The ultrasound features enabling the early detection of trisomy 18 include a delayed ossification of calvarium combined with early onset of fetal growth restriction [FGR] and the absence of nasal bone through performing triple test followed by amniocentesis. Finally, the parents decided to terminate the pregnancy

Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus

Background: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too

Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound [2-DUS] and real time three dimensional ultrasound [3-DUS] in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard

Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study [unicornuate, bicornuate and didelphys anomalies]. The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic [ROC] curve, cut off points for predicting the kind of anomalies were proposed

Results: The women were evaluated by 2-DUS [n=89] and [II] 3-DUS [n=126]. All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa [K] index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate

Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS

Uterine cavity assessment in infertile women: sensitivity and specificity of three-dimensional hysterosonography versus hysteroscopy

Assessment of uterine abnormalities is a core part in infertility evaluation. The aim of this study was to evaluate the sensitivity and specificity of three-dimensional hysterosonography [3-DHS] in the diagnosis of uterine abnormalities in infertile women. The infertile women who visited Royan Institute and referred to 3-DHS consecutively, prior to in vitro fertilization, from 2010-2011 included in this cross-sectional study. For patients who underwent hysteroscopy in addition to 3-DHS [214/977], the verification bias adjusted sensitivity and specificity of 3-DHS which were calculated by global sensitivity analysis method. Hysteroscopy was used as the gold standard for diagnosis of uterine abnormalities. Histological diagnosis of resected endometrial tissues by hysteroscopy was assessed and the adjusted sensitivity and specificity of 3-DHS and hysteroscopy in detection of polyp or hyperplasia were determined. Histopathologic results were considered as the gold standard for diagnosis of polyp or hyperplasia. The overall sensitivity and specificity for 3-DHS in diagnosis of uterine anomalies considering hysteroscopy as the gold standard were 68.4% and 96.3% respectively. Sensitivity and specificity of hysteroscopy in diagnose of polyp or hyperplasia was calculated at 91.3% and 81.4% respectively. Sensitivity and specificity of 3-DHS in diagnosis polyps or hyperplasia was calculated at 91.4% and 80.2% respectively. The results of present study proved that, compared to hysteroscopy; 3-DHS has a reliable specificity for diagnosis of uterine abnormalities. Sensitivity and specificity of 3-DHS and hysteroscopy in detecting polyp or hyperplasia regarding histopathology as the gold standard was the same

Application of 3D ultrasonography in detection of uterine abnormalities

Structural pathologies in the uterine cavity such as m_llerian duct anomalies [MDAs] and intrauterine lesions [fibroids, polyps, synechiae] may have important roles in subinfertility, implantation failure and pregnancy outcome. Various imaging modalities such as hysterosalpingography [HSG], sonography, laparoscopy and hysteroscopy are used in the evaluation of MDAs and intrauterine lesions. Recently, three-dimensional ultrasound [3DUS] has been introduced as a non-invasive, outpatient diagnostic modality. With increased spatial awareness, it is superior to other techniques used for the same purpose

Holoprosencephaly: a case report and review of prenatal sonographic findings

Holoprosencephaly is a rare intracranial abnormality. The incidence of holoprosencephaly is between 0.56-0.63 of 10,000 live-born infants 10. It has classified into three degrees, alobar, semilobar and lobar. In this case report we are introducing a case of Holoprosencephaly, in 13 weeks of pregnancy which was twin. We could identified this abnormality and the reduction was done in the appropriate time. The role of prenatal sonography in recognition of the malformation and prognostic value of these features are discussed