ABSTRACT
Objective To determine the imaging features and clinical value of first-trimester ultrasonographic screening of fetal megacystis in multifetal pregnancy.Methods Retrospective analysis was undertaken in 2159 cases of multifetal pregnancy screened in our hospital at gestational age from 11th to 13 + 6th weeks by color Doppler ultrasound between Jan 2011 and April 2016.Fetal bladder was defined by showing two umbilical arteries and the longitudinal length of the bladder was measured in mid-sagittalplane.Clinical progression of fetal megacystis diagnosed in first-trimester were followed and the outcomes were recorded.Results Totally six cases of fetal megacystis in multifetal pregnancy were detected,in which five cases were detected in one fetus of twin pregnancy and the other case was detected in one fetus of triplet pregnancy.In all cases of fetal megacystis,longitudinal length of the fetal bladder was more than 7 mm and double umbilical arteries were detected.In two cases of naturally-occurring twin pregnancy,abortion was performed and postnatal autopsy revealed prune belly syndrome.In the rest four cases of multifetal pregnancy through in vitro fertilization-embryo transfer (IVF-ET),two cases of twin pregnancies underwent selective feticide.The other two cases of twin and triplet pregnancies refused intervention,among which still birth happened in the megacystis fetus and spontaneous fetal death at gestational age of 13 + 2 weeks happened in the monochorionic monoamniotic twins of the triplet pregnancy.Totally,four live babies were born,among which three were healthy.The other baby was found to have 1.5 Mb deletion in chromosome 17q12 by microarray at gestational age of 32 weeks due to increased renal echogenicity.Conclusions First-trimester ultrasonography can effectively detect and diagnose megacystis in multifetal pregnancy.Early diagnosis and timely intervention are helpful for improving the outcome of fetal megacystis in multifetal pregnancy.
ABSTRACT
Objective To evaluate the value of prenatal ultrasonography in diagnosis of in vitro fertilization-embryo transfer (IVF-ET) fetal abnormalities during early trimester. Methods A total of 685 IVF-ET pregnant women received Doppler color ultrasound in our hospital during 11-13+6 weeks of pregnancy from January 2010 to December 2010; the number of fetal, polyembryony chorion, and gestational age were examined; and the abnormal structures were screened. Based on findings of sonographic markers, chorionic villi sampling was done for some fetals. Amniocentesis or selective reduction was done when triplet or one of the twins found with lethal abnormality. All the cases were followed up for pregnancy process and clinical results. Results Among the 685 IVF-ET pregnant women, 440 had singleton pregnancy (64. 23%), 244 had twin pregnancy (35. 62%), and only one had triplet pregnancy (0. 15%). Seven fetal abnormalities were detected in singleton pregnancies during early trimester, and five cases were clinically confirmed. Six fetal abnormalities were detected in twin pregnancies during early trimester, and three cases were clinically confirmed. Excluding the triplet pregnancy, the total incidence rate of abnormal fetal was 0. 86%(8/928), with two cases confirmed by chromosomal abnormality screening and two cases receiving selective reduction operation. Conclusion Standardized prenatal ultrasonography during early trimester(11-13+6 weeks) can improve the accurate screening rate of fetal abnormalities for IVF-ET pregnancy, and can help to deal with multiple pregnancy and abnormal fetals.