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We report a fetus with ectopic connection of venous catheter into the dilated coronary sinus, right-sided aortic arch, left-sided ductal arch, and aberrant left subclavian artery detected by routine prenatal ultrasound screening at 23 +2 gestational weeks. The baby was born vaginally at 38 +2 gestational weeks with an Apgar score of 10 at both 1 and 5 min. The reexamination of neonatal echocardiography on the second day after birth showed dilation of the internal diameter of the coronary sinus, right-sided aortic arch, and aberrant left subclavian artery. Follow-up at 90 days after birth found no abnormal growth and development.
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We report a case of suspected fetal congenital glaucoma detected by prenatal ultrasound. The mother had no history of cold, medication, or radiation exposure in the first trimester. Routine prenatal ultrasound at 23 +2 weeks of gestation found a 2.5 mm ventricular septum defect, and the sagittal and transverse diameters of the left and right eyeballs were all greater than the normal range of the same gestational weeks, which were noted at 18.57 mm and 17.26 mm, 18.21 mm and 17.22 mm, respectively. Dynamic observation revealed that the bilateral eyelids were unable to close with cornea being exposed to amniotic fluid. The pregnancy was terminated at 23 +6 weeks and a stillborn female weighing 650 g was delivered two days later. Congenital glaucoma was highly suspected by postnatal ophthalmic examination, accompanied by a deformity of the left thumb. No abnormality was detected on fetal chromosome karyotyping or whole-exon sequencing. When unilateral or bilateral megalophthalmos in the fetus is detected by prenatal ultrasound, congenital glaucoma should be considered.
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We reported a case of fetus with right atrial isomerism diagnosed by ultrasound prenatally. Right atrial isomerism was suspected based on several kinds of abnormalities detected at 24 gestational weeks by ultrasound imaging, such as levocardia complicated by complex cardiovascular malformations (double outlet of right ventricle, atrioventricular septal defect, pulmonary artery dysplasia, bilateral superior vena cava and infracardiac total anomalous pulmonary venous drainage), abnormal right-sided stomach bubble, midline liver, suspicious absence of the spleen, juxtaposition of the abdominal aorta and the inferior vena cava to the left side, and mirror-image right bronchia. Autopsy confirmed all of the prenatal diagnosis with an additional finding of splenic dysplasia. Right atrial isomerism should be considered when ultrasound findings indicate complex cardiovascular malformations. Given the high mortality rate of right atrium isomerism, prenatal diagnosis is of great importance.
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Objective:To construct and confirm a predictive model for the risks of cardiovascular diseases (CVD) with metabolic syndrome (MS) and its factors in Xinjiang Kazakh population.Methods:A total of 2 286 Kazakh individuals were followed for 5 years from 2010 to 2012 as baseline survey. They were recruited in Xinyuan county, Yili city, Xinjiang. CVD cases were identified via medical records of the local hospitals in 2013, 2016 and 2017, respectively. Factor analysis was performed on 706 MS patients at baseline, and main factors, age, and sex were extracted from 18 medical examination indexs to construct a predictive model of CVD risk. After excluding the subjects with CVD at baseline and incomplete data, 2007 were used as internal validation, and 219 Kazakhs in Halabra Township were used as external validation. Logistic regression discriminations were used for internal validation and external validation, as well as to calculate the probability of CVD for each participant and receiver operating characteristic curves.Results:The prevalence of MS in Kazakh was 30.88%. Seven main factors were extracted from the Kazakh MS population, namely obesity factor, blood lipid and blood glucose factor, liver function factor, blood lipid factor, renal metabolic factor, blood pressure factor, and liver enzyme factor. The area under the curve (AUC) for predicting CVD in the internal validation was 0.773 (95% CI 0.754-0.792). In the external validation, the AUC for predicting CVD was 0.858 (95% CI 0.805-0.901). Conclusions:The CVD risk prediction model constructed by 7 main factors extracted from Kazakh MS patients has high validation efficiency and can be used for risk assessment of CVD in Xinjiang Kazakh population.
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Objective@#To construct and confirm a predictive model for the risks of cardiovascular diseases (CVD) with metabolic syndrome (MS) and its factors in Xinjiang Kazakh population.@*Methods@#A total of 2 286 Kazakh individuals were followed for 5 years from 2010 to 2012 as baseline survey. They were recruited in Xinyuan county, Yili city, Xinjiang. CVD cases were identified via medical records of the local hospitals in 2013, 2016 and 2017, respectively. Factor analysis was performed on 706 MS patients at baseline, and main factors, age, and sex were extracted from 18 medical examination indexs to construct a predictive model of CVD risk. After excluding the subjects with CVD at baseline and incomplete data, 2007 were used as internal validation, and 219 Kazakhs in Halabra Township were used as external validation. Logistic regression discriminations were used for internal validation and external validation, as well as to calculate the probability of CVD for each participant and receiver operating characteristic curves.@*Results@#The prevalence of MS in Kazakh was 30.88%. Seven main factors were extracted from the Kazakh MS population, namely obesity factor, blood lipid and blood glucose factor, liver function factor, blood lipid factor, renal metabolic factor, blood pressure factor, and liver enzyme factor. The area under the curve (AUC) for predicting CVD in the internal validation was 0.773 (95%CI 0.754-0.792). In the external validation, the AUC for predicting CVD was 0.858 (95%CI 0.805-0.901).@*Conclusions@#The CVD risk prediction model constructed by 7 main factors extracted from Kazakh MS patients has high validation efficiency and can be used for risk assessment of CVD in Xinjiang Kazakh population.
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Objective To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease( CVD) among Kazakhs. Methods The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve. Results The incidence of CVD was 13.87％. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59％ vs 11.10％, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001);the area under the curve of MS risk score was close to that of Framingham risk score ( 0. 732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61、9.33、14.15、22.29对3.69、6.36、8.47、16.99) . Conclusion MS risk score that included age may be a better predictor of CVD among Kazakhs.
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Objective@#To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease(CVD)among Kazakhs population.@*Methods@#The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve.@*Results@#The incidence of CVD was 13.87%. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59% vs 11.10%, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001); the area under the curve of MS risk score was close to that of Framingham risk score(0.732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61, 9.33, 14.15, 22.29 vs 3.69, 6.36, 8.47, 16.99).@*Conclusion@#MS risk score that included age may be a better predictor of CVD among Kazakhs population.
ABSTRACT
Cor triatriatum sinister (CTS) is characterized by the presence of a fibromuscular membrane dividing the left atrium into two chambers. The postero-superior and proximal chamber of CTS receives blood from four pulmonary veins, whereas the antero-inferior and distal chamber (true left atrium) connects to mitral valve and left atrial appendage (LAA). CTS can be classified into two types, complete and partial CTS. We reported a case of fetal autopsy-confirmed complete CTS that had been misdiagnosed as atresia of the common pulmonary vein on prenatal ultrasound. At 25 gestational weeks, fetal sonography revealed that the pulmonary venous angle on the top of the left atrium disappeared and no vertical vein was found around the common pulmonary venous cava formed by bilateral pulmonary veins. Thus, atresia of the common pulmonary venous cava was considered. Fetal autopsy after induction further confirmed the case was complete CTS.
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Cor triatriatum sinister (CTS) is characterized by the presence of a fibromuscular membrane dividing the left atrium into two chambers. The postero-superior and proximal chamber of CTS receives blood from four pulmonary veins, whereas the antero-inferior and distal chamber (true left atrium) connects to mitral valve and left atrial appendage (LAA). CTS can be classified into two types, complete and partial CTS. We reported a case of fetal autopsy-confirmed complete CTS that had been misdiagnosed as atresia of the common pulmonary vein on prenatal ultrasound. At 25 gestational weeks, fetal sonography revealed that the pulmonary venous angle on the top of the left atrium disappeared and no vertical vein was found around the common pulmonary venous cava formed by bilateral pulmonary veins. Thus, atresia of the common pulmonary venous cava was considered. Fetal autopsy after induction further confirmed the case was complete CTS.
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We reported a case of trisomy 18 with Abernethy malformation diagnosed by prenatal ultrasound, which was confirmed by chromosome karyotyping after cordocentesis and fetal autopsy. At 24 gestational weeks, fetal sonography revealed a fetus with multiple malformations (cleft lip/cleft palate of left side, left radial dysplasia, hooked hands, bilateral pes valgus, ventricular septal defect, and congenital extrahepatic portocaval shunt), which was diagnosed as trisomy 18 syndrome with Abernethy malformation. The fetus's karyotype was 47, XX+18.