Ductus venosus as a marker of fetal growth in first trimester in a population of Colombian pregnant women / Ductus venoso como marcador de crecimiento fetal en primer trimestre en una población de gestantes colombianas

Abstract Objectives: to evaluate the relationship between the ductus venosus (DV) and the variables of fetal growth in the first trimester in a Colombian pregnant population. Methods: a descriptive cross-sectional study was carried out with secondary data obtained from a multicenter study.526 patients were included between weeks 11 and 14 for gestational ultrasound follow-up attended in three health care institutions in Bogotá, Colombia, between May 2014 and October 2018. A bivariate descriptive analysis was carried out where the relationship between the characteristics of the DV in the first trimester and ultrasound findings. Results: the flow wave of the DV in the first trimester was normal in the entire sample, with a pulsatility index of the ductus venosus (DVPI) of 0.96±0.18. In addition, a negative correlation was found between the crown-rump length (CRL) and the DVPI (p<0.05). Conclusion: there is a relationship between the DVPI regarding the CRL, indicating an interest in this early marker in relation to fetal growth alterations; however, more studies are required to determine the usefulness of this variable with respect to fetal growth.

Resumen Objetivos: evaluar la relación entre el ductus venoso (DV) y las variables del crecimiento fetal en primer trimestre en una población de gestantes colombianas. Métodos: se realizó un estudio transversal descriptivo con datos secundarios obtenidos de un estudio multicéntrico. Se incluyeron 526 pacientes entre las semanas 11 a 14 para seguimiento ecográfico gestacional atendidas en tres instituciones prestadoras de salud en Bogotá, Colombia, entre mayo del 2014 y octubre del 2018. Se realizó un análisis descriptivo bivariado donde se evaluó la relación entre las características del DV en primer trimestre y los hallazgos ecográficos. Resultados: la onda de flujo del DV en primer trimestre fue normal en la totalidad de la muestra, con un índice medio de pulsatilidad del ductus venoso (IPDV) de 0,96±0.18. Se encontró una correlación negativa entre la longitud cefalocaudal (LCC) y el IPDV (p<0.05). Conclusión: existe una relación entre el IPDV respecto a la LCC, señalando un interés de este marcador temprano en relación con las alteraciones del crecimiento fetal, sin embargo, se requieren más estudios para determinar la utilidad entre esta variable respecto al crecimiento fetal

Twin pregnancies, crown-rump length and birthweight discordancy: the influence of chorionicity / Gestações gemelares, comprimento craniocaudal e discordância de peso ao nascimento: a influência da corionicidade

Abstract Objective The purpose of the present study was to analyze the influence of chorionicity in the biometric parameters crown-rump length (CRL), birthweight (BW), crown-rump length discordancy (CRLD) and birthweight discordancy (BWD), determine the correlation between these latter two in cases of intertwin discordancy, and to analyze the influence of chronicity in the presence of these discordancies with clinical relevance (> 10% and > 15%, respectively). Methods The present study was a retrospective study based on the twin pregnancy database of the Centro Hospitalar S. João (2010-2015), including 486 fetuses among 66 monochorionic (MC) and 177 dichorionic gestations (DC). The inclusion criteria were multiple pregnancies with 2 fetuses and healthy twin gestations. The exclusion criteria were trichorionic gestations and pregnancies with inconclusive chorionicity, multiple pregnancy with ≥ 3 fetuses and pathological twin gestations. Results No statistically significant difference was found in BW (p = 0.09) and in its discordancy (p = 0.06) nor in CRL (p = 0.48) and its discordancy (p = 0.74) between MCs and DCs. Crown-rump length discordancy and birthweight discordancy were correlated by the regression line "BWD = 0.8864 x CRLD + 0.0743," with r2 = 0.1599. Crown-rump length discordancy > 10% was found in 7.58% of monochorionic and in 13.56% of dichorionic twins. Birthweight discordancy > 15% was detected in 16.67% of monochorionic and in 31.64% of dichorionic twins. Conclusion No statistically significant influence of chorionicity was identified in both birthweight and birthweight discordancy, as in crown-rump length and crown-rump length discordancy. Birthweight discordancy was correlated to crown-rump length discordancy in 20% of cases.

Resumo Objetivo O objetivo do presente estudo foi analisar a influência da corionicidade nos parâmetros biométricos comprimento craniocaudal, peso ao nascimento, discordância de comprimento craniocaudal e discordância de peso ao nascimento, determinar a correlação entre estes dois últimos caso haja discordância intergemelar e analisar a influência da corionicidade na presença destas discordâncias com relevância clínica (> 10% e > 15%, respectivamente). Métodos O presente estudo foi um estudo retrospectivo baseado na base de dados de gestações gemelares do Centro Hospitalar S. João (2010-2015), incluindo 486 fetos de 66 gestações monocoriônicas e 177 dicoriônicas. Os critérios de inclusão foram gestações múltiplas de 2 fetos e gestações gemelares saudáveis. Os critérios de exclusão foram gestações tricoriônicas ou de corionicidade inconclusiva, gestações múltiplas com ≥ 3 fetos e gestações gemelares patológicas. Resultados Não se encontrou diferença estatisticamente significativa no peso ao nascimento (p =0,09) e sua discordância (p = 0,06) nem no comprimento craniocaudal (p = 0,48) e sua discordância (p = 0,74) entre gestações monocoriônicas e dicoriônicas. Considerando todas as gestações, as discordâncias de comprimento craniocaudal e peso ao nascimento foram correlacionadas pela reta de regressão "discordância de peso ao nascimento = 0.8864 x discordância de comprimento craniocaudal + 0.0743," com r2 = 0,1599. A discordância de comprimento craniocaudal > 10% descobriu-se em 7.58% das gestações monocoriônicas e em 13.56% das dicoriônicas. A discordância de peso ao nascimento > 15% detectou-se em 16.67% das gestações monocoriônicas e em 31.64% das dicoriônicas. Conclusão Não se identificou influência estatisticamente significativa no peso ao nascimento e sua discordância, bem como no comprimento craniocaudal e sua discordância. A discordância de peso ao nascimento correlacionou-se com a discordância de comprimento craniocaudal em 20% dos casos.

Intrauterine growth curves for body weight, body length, head circumference, chest circumference, and crown-rump length in 16 887 neonates with a gestational age of 27-42 weeks in Shenzhen, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To establish the intrauterine growth curves of neonates in Shenzhen, China and to investigate the intrauterine growth of neonates in Shenzhen.</p><p><b>METHODS</b>Cross-sectional cluster sampling was performed for an on-the-spot investigation of 16 887 neonates (9 418 males and 7 469 females) with a gestational age of 27-42 weeks who were born in two hospitals in Shenzhen from April 2013 to September 2015. The Lambda Mu Sigma (LMS) method was used for the curve fitting of body weight, body length, head circumference, chest circumference, and crown-rump length.</p><p><b>RESULTS</b>The 3rd-97th percentile intrauterine growth curves for body weight, body length, head circumference, chest circumference, and crown-rump length were plotted for the neonates with a gestational age of 27-42 weeks who were divided into three groups (male, female, and mixed). The male neonates had significantly higher curves for the five indices than the female counterparts. The pattern and changing trend of body weight curves of these neonates were basically consistent with those in China Neonatal Network.</p><p><b>CONCLUSIONS</b>The percentile intrauterine growth curves for body weight, body length, head circumference, chest circumference, and crown-rump length in neonates with a gestational age of 27-42 weeks in Shenzhen which has been established can provide a reference for clinical practice in the department of neonatology.</p>

Is there a trans-abdominal testicular descent during the second gestational trimester? Study in human fetuses between 13 and 23 weeks post conception

ABSTRACT Objectives To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring. Material and Methods Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test. Results The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied. Conclusions The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester.

Correlation analysis of fetal middle cerebral artery peak systolic velocity, cardiothoracic ratio and crown-rump length in early pregnancy / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the pattern of variations in middle cerebral artery peak systolic velocity (MCA PSV) and cardiothoracic ratio (CTR) during early pregnancy, establish their reference ranges and explore their correlation with the crown-rump length (CRL).</p><p><b>METHODS</b>A total of 522 pregnant women with normal findings in antenatal examinations underwent routine color Doppler ultrasound examination to collect the data of MCA PSV, CTR and CRL. The reference ranges of MCA PSV and CTR for different CRL levels were established, and the correlation of MCA PSV and CTR with CRL was analyzed.</p><p><b>RESULTS</b>During the first trimester, MCA PSV and CRL showed a moderate positive correlation with a correlation coefficient of 0.426 (P<0.001), while CTR and CRL showed no significant correlation (0.168, P<0.001). The reference range of MCA PSV was 14.35 (14.08-14.62) cm/s and that of CTR was 0.34 (0.33-0.34) during early pregnancy.</p><p><b>CONCLUSION</b>Color Doppler ultrasound is a safe and feasible modality to assess fetal MCA PSV and CTR for detecting fetal growth abnormalities in early pregnancy. The established reference ranges of MCA PSV and CTR offer a clinical theoretical basis for detecting α-thalassemia in early pregnancy.</p>

Screening for chromosomal abnormalities using combined test in the first trimester of pregnancy

OBJECTIVE: This study was designed to review the screening performance of combined test at the Ewha Womans University Mokdong hospital. METHODS: All women admitted for routine antenatal care between January 1st 2008 and December 31st 2012 with a known pregnancy outcome were included in this study, totaling 1,156 women with singleton pregnancies presenting at 10 to 13 weeks of gestation. Women were offered screening using a combination of maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and fetal nuchal translucency thickness. Those with an estimated risk of ≥1 in 250 of carrying a fetus with trisomy 21 or ≥1 in 300 risk of trisomy 18 were offered genetic counseling with the option of an invasive diagnostic test. RESULTS: The median of gestational age was 11+3 weeks, the median of crown-rump length was 47.1 mm, and the median age of the women was 31 years. The detection rate was 80% for trisomy 21 (4 of 5) and 100% for trisomy 13 and 18 (all 2). The false-positive rate was 7.73% for trisomy 21 and 1.21% for trisomy 18. CONCLUSION: This study was the first large population study performed with the aim of analyzing the performance of the combined test in Korea. This study demonstrated that the detection rates and other figures of the first trimester combined test are comparable to the results reported in other papers worldwide. Consequently, if strict conditions for good screening outcomes are achieved, the first trimester combined test might well be the earliest detectable screening, improving detection rates without increasing karyotyping or economic and other implications that inevitably ensue.

Screening for chromosomal abnormalities using combined test in the first trimester of pregnancy

OBJECTIVE: This study was designed to review the screening performance of combined test at the Ewha Womans University Mokdong hospital. METHODS: All women admitted for routine antenatal care between January 1st 2008 and December 31st 2012 with a known pregnancy outcome were included in this study, totaling 1,156 women with singleton pregnancies presenting at 10 to 13 weeks of gestation. Women were offered screening using a combination of maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and fetal nuchal translucency thickness. Those with an estimated risk of ≥1 in 250 of carrying a fetus with trisomy 21 or ≥1 in 300 risk of trisomy 18 were offered genetic counseling with the option of an invasive diagnostic test. RESULTS: The median of gestational age was 11+3 weeks, the median of crown-rump length was 47.1 mm, and the median age of the women was 31 years. The detection rate was 80% for trisomy 21 (4 of 5) and 100% for trisomy 13 and 18 (all 2). The false-positive rate was 7.73% for trisomy 21 and 1.21% for trisomy 18. CONCLUSION: This study was the first large population study performed with the aim of analyzing the performance of the combined test in Korea. This study demonstrated that the detection rates and other figures of the first trimester combined test are comparable to the results reported in other papers worldwide. Consequently, if strict conditions for good screening outcomes are achieved, the first trimester combined test might well be the earliest detectable screening, improving detection rates without increasing karyotyping or economic and other implications that inevitably ensue.

Screening ultrasonography in pregnancy

Ultrasonography in obstetrics is increasingly used for the screening of chromosomal abnormalities as well as for prenatal diagnosis of congenital abnormalities with safety and technological advancements. In the first trimester, it is important to confirm normal intrauterine pregnancy with viability, detect the abnormalities of uterus and adnexa, determine the number of fetuses and assess chorionicity and amnionicity in case of multiple pregnancy. After establishment of gestational age accurately by crown-rump length, thickened fetal nuchal translucency, absence of nasal bone, tricuspid regurgitation, reverse a wave of ductus venosus and cystic hygroma can be markers for screening of chromosomal abnormalities. In addition, the scan also offers an opportunity to detect gross structural abnormalities, which could help improve the prognosis by early prenatal intervention. In the second trimester, aneuploidy (trisomy 21, 18, 13, Turner syndrome) and genetic syndromes could be detected by major structural defects and soft markers. It is important to consider that many malformations may not be detected prenatally even by qualified practitioners and appropriate equipment, and to counsel patients about the potential for false-positive or false-negative results.

Comparison of growth and pubertal progression in wild type female rats with different bedding types

PURPOSE: Endocrine-disrupting chemicals interfere with the endocrine system and therefore affect growth and pubertal progression. The study aim was to compare the growth and pubertal progression in wild-type female rats with different bedding types. METHODS: Twenty 5-week-old female wild-type Sprague Dawley rats were randomly assigned to two groups with different bedding types: one group received wood shaving bedding, while a second group received corncob bedding. We determined crown-rump length and body weight as anthropometric measurements and assessed the serum growth hormone (GH) and estradiol levels. The gh1 mRNA expression levels were compared using quantitative real time transcription polymerase chain reaction. The estrous cycle was evaluated by vaginal smear. RESULTS: The anthropometric measurements were not significantly different between the two groups. The mean relative expression of the gh1 gene was lower in the corncob bedding group than that in the wood shaving group (P=0.768). Meanwhile serum GH and estradiol were increased in the wood shaving bedding group; however this difference was not statistically significant. The time to first estrus and the length of the estrous cycle were increased in the corncob bedding group; the proportion of normal estrous cycles was also decreased. These findings indicate irregularities in the estrous cycle. CONCLUSION: Endocrine-disrupting chemicals in corncob bedding might be associated with time to first estrus and length of the estrous cycle. Therefore, the type of bedding should be considered as a factor affecting pubertal progression in rodents.

Upper terminal of the inferior vena cava and development of the heart atriums: a study using human embryos / 대한해부학회지

In the embryonic heart, the primitive atrium is considered to receive the bilateral sinus horns including the upper terminal of the inferior vena cava (IVC). To reveal topographical anatomy of the embryonic venous pole of the heart, we examined horizontal serial paraffin sections of 15 human embryos with crown-rump length 9-31 mm, corresponding to a gestational age of 6-7 weeks or Carnegie stage 14-16. The IVC was often fixed to the developing right pulmonary vein by a mesentery-like fibrous tissue. Rather than the terminal portion of the future superior vena cava, the IVC contributed to form a right-sided atrial lumen at the stage. The sinus venosus or its left horn communicated with the IVC in earlier specimens, but in later specimens, the left atrium extended caudally to separate the sinus and IVC. In contrast, the right atrium consistently extended far caudally, even below the sinus horn, along the IVC. A small (or large) attachment between the left (or right) atrium and IVC in adult hearts seemed to be derived from the left (or right) sinus valve. This hypothesis did not contradict with the incorporation theory of the sinus valves into the atrial wall. Variations in topographical anatomy around the IVC, especially of the sinus valves, might not always depend on the stages but partly in individual differences.

Avaliação do coração fetal no primeiro trimestre de gestação: influência do comprimento cabeça-nádega e índice de massa corporal materna / Fetal heart assessment in the first trimester of pregnancy: influence of crown-rump length and maternal body mass index

OBJETIVO: Avaliar a influência do comprimento cabeça-nádega e do índice de massa corporal na avaliação ultrassonográfica do coração fetal, pelas vias abdominal e vaginal, no primeiro trimestre de gestação. MÉTODOS: Realizou-se um estudo de corte transversal com 57 gestantes normais entre 12 a 14 semanas (CCN < 84 mm). Foram avaliados os seguintes planos cardíacos, pelas vias abdominal e vaginal: quatro câmaras, via de saída do ventrículo direito, via de saída do ventrículo esquerdo e arco aórtico. Utilizou-se o modo B, Doppler colorido e ultrassonografia de quarta dimensão (spatio-temporal image correlation). Para avaliar a influência do comprimento cabeça-nádega e índice de massa corporal na avaliação dos planos cardíacos fetal, utilizou-se o teste t não-pareado. RESULTADOS: Não se observou diferenças estaticamente significativas nas taxas de sucesso e insucesso entre as vias abdominal e vaginal em relação ao índice de massa corporal, contudo, observou-se maior taxa de insucesso na avaliação vaginal utilizando o modo B associado ao Doppler colorido (P<0,01). CONCLUSÃO: O índice de massa corporal e o comprimento cabeça-nádega não tiveram interferência na avaliação cardíaca fetal no primeiro trimestre de gestação.

OBJECTIVE: To evaluate the influence of the crown-rump length and body mass index on sonographic evaluation of the fetal heart using abdominal and vaginal routes in the first trimester of pregnancy. METHODS: We conducted a cross-sectional study with 57 pregnant women between 12-14 weeks (CRL< 84 mm). We evaluated the following fetal cardiac plans using the abdominal and vaginal routes: four-chamber view, right ventricle outflow tract, left ventricle outflow tract and aortic arch. We used the B-mode, color Doppler and four-dimensional ultrasonography (spatio-temporal image correlation). To evaluate the influence of crown-rump length and body mass index in the assessment of fetal cardiac planes, we used the t test unpaired. RESULTS: There were no statistically significant differences in the rates of success and failure between abdominal and vaginal routes in relation to body mass index, however, there was a higher failure rate in vaginal assessment using B mode associated with color Doppler (P<0.01). CONCLUSION: The crown-rump length and body mass index had no interference in fetal cardiac assessment in the first trimester of pregnancy.

Simplified protocol of nuchal translucency measurement: Is it still effective?

OBJECTIVE: Nuchal translucency (NT) is the most powerful screening tool for Down syndrome and congenital cardiac anomaly, therefore strict guidelines were established to get accurate NT values. However, to stick to the guideline in all pregnant women is time-consuming and superfluous in majority of low risk population. We undertook this study to investigate whether the simplified protocol enables to select low risk group and is effective in them even if we skip the suggested NT measurement. METHODS: NT and crown-rump length (CRL) were measured prospectively. First, CRL was measured in the ordinary view that was mid-sagittal section of fetus in neutral position, and NT was measured at the same frozen screen (first measured value, 1MV). Then, NT was measured again according to the Fetal Medicine Foundation (FMF) guideline (second measured value, 2MV). RESULTS: There was good correlation between 1MV and 2MV in each case (r = 0.83, P or = 2 mm was only 23.8% of all cases, namely we had only to measure 2MV in 23.8% patients. Every 95th percentile or more 2MV could be detected with this simplified protocol. CONCLUSION: If NT is less than 2 mm at ordinary CRL view, we may skip suggested NT measurement according to FMF guideline.

Crown-Rump Length Measured in the Early First Trimester as a Predictor of Low Birth Weight

The aim of this study is to assess the association between crown-rump length (CRL) measured before the 10th gestational week and birth weight. Results from 316 transvaginal ultrasonography scans at the 46th, 53rd, 60th, 67th, and 74th days of pregnancy were compared in low birth weight (LBW) versus normal birth weight groups. A positive correlation between CRL and birth weight was observed when CRL was measured at days 60, 67, and 74. CRL measured on the 67th day of pregnancy was significantly smaller in the LBW group than in the normal birth weight group. A cut-off value of CRL=26.5 mm measured at day 67 has the highest power to predict LBW.

Estimation of gestational age according to crown-rump length in nepalese population: a comparison with previously published nomograms

This study was performed to construct an institution specific crown-rump length [CRL] nomogram and to compare its ability to predict gestational age with previously published nomograms. A regression model was developed for estimation of gestational age using CRL measurements of 123 singleton fetuses in the Nepalese population. Measurements were obtained by placing the calipers of the ultrasound machine from the crown to the rump. The appropriateness of previously established CRL nomograms for predicting the gestational age was assessed in the Nepalese population to determine comparability between nomograms. CRL corresponds to Robinsons' nomogram up to 9 weeks of gestational age. There is a deficiency of 2 mm at 10 weeks. 5 mm at 11 weeks and 8 mm at 12 weeks. CRL measurements are used as a reliable method for estimation of the gestational age as well as baseline for comparing gestational ages later. CRL corresponds to Robinsons' nomogram up to 9 weeks gestational age. There is a deficiency of 2-8 mm from 10-12 weeks gestational age. Difference with the established nomograms may be due to ethnic differences of the fetal development. After 12 weeks, CRL measurement is unreliable due to flexion of the fetus

[Developmental study of prenatal goat testis]

There are some reports about development of prenatal ruminants' testis. But there is not any report about it in goat; so the present study was performed on 23 goats fetuses collected from Ahvaz slaughterhouse. After measuring fetuses crown rump length [CRL], their approximate ages were determined. On the basis of the CRL, the fetuses were divided into 6 groups. Then testes were extruded out and fixed and tissue sections were prepared by routine procedures and then were stained with Hematoxylin and Eosin and Periodic Acid Schiff. The biometric results showed a reasonable increase in the number of sertoli cells and gonocytes, diameter of sex cord and tunica albuginea during the development age dependences. The number of sex cords in each microscopic field showed an increase first and decreased thereafter. There is no difference between prenatal goat testis developments with prenatal testicular stages in other ruminants

Volume do embrião estimado pela ultra-sonografia tridimensional entre a sétima e a décima semana de gestação / Embryo volume estimated by three-dimensional ultrasonography at seven to ten weeks of pregnancy

OBJETIVO: avaliar a evolução do volume do embrião (VE) entre a sétima e a décima semana de gestação por meio da ultra-sonografia tridimensional. MÉTODOS: realizou-se um estudo de corte transversal com 63 gestantes normais entre a sétima e a décima semana. Os exames ultra-sonográficos foram realizados por meio de um transdutor endocavitário volumétrico. Para o cálculo do VE, utilizou-se o método VOCAL (Virtual Organ Computer-aided Analysis) com ângulo de rotação de 12º, com delimitação de 15 planos seqüenciais. Para o VE foram calculadas médias, medianas, desvios padrão e valores máximo e mínimo em todas as idades gestacionais. Para se avaliar a correlação entre o VE e o comprimento cabeça-nádega (CCN) foi criado gráfico de dispersão, sendo o ajuste realizado pelo coeficiente de determinação (R²). Para se determinarem intervalos de referência do VE em função do CCN, utilizou-se a seguinte fórmula: percentil =VE+K versus dp, com K=1,96. RESULTADOS: o CCN variou de 9,0 a 39,7 mm, com média de 23,9 mm (±7,9 mm), enquanto o VE variou de 0,1 a 7,6 cm³, com média de 2,7 cm³ (±3,2 cm³). O VE foi altamente correlacionado com o CCN, sendo que o melhor ajuste foi obtido com regressão quadrática (VE=0,165 - 0,055 x CCN + 0,005 x CCN²; R²=0,853). O VE médio variou de 0,1 (-0,3 a 0,5 cm³) a 6,7 cm³ (3,8 a 9,7 cm³) no intervalo de 9 a 40 mm do CCN. Neste intervalo o VE aumentou 67 vezes, enquanto o CCN aumentou apenas 4,4 vezes. CONCLUSÕES: o VE é um parâmetro mais sensível que o CCN para avaliar o crescimento embrionário entre a sétima e a décima semana de gestação.

PURPOSE: to evaluate the embryo's volume (EV) between the seventh and the tenth gestational week, through tridimensional ultrasonography. METHODS: a transversal study with 63 normal pregnant women between the seventh and the tenth gestational week. The ultrasonographical exams have been performed with a volumetric abdominal transducer. Virtual Organ Computer-aided Analysis (VOCAL) has been used to calculate EV, with a rotation angle of 12º and a delimitation of 15 sequential slides. The average, median, standard deviation and maximum and minimum values have been calculated for the EV in all the gestational ages. A dispersion graphic has been drawn to assess the correlation between EV and the craniogluteal length (CGL), the adjustment being done by the determination coefficient (R²). To determine EV's reference intervals as a function of the CGL, the following formula was used: percentile=EV+K versus SD, with K=1.96. RESULTS: CGL has varied from 9.0 to 39.7 mm, with an average of 23.9 mm (±7.9 mm), while EV has varied from 0.1 to 7.6 cm³, with an average of 2.7 cm³ (±3.2 cm³). EV was highly correlated to CGL, the best adjustment being obtained with quadratic regression (EV=0.2-0.055 versus CGL+0.005 versus CGL²; R²=0.8). The average EV has varied from 0.1 (-0.3 to 0.5 cm³) to 6.7 cm³ (3.8 to 9.7 cm³) within the interval of 9 to 40 mm of CGL. EV has increased 67 times in this interval, while CGL, only 4.4 times. CONCLUSIONS: EV is a more sensitive parameter than CGL to evaluate embryo growth between the seventh and the tenth week of gestation.

Use of three dimensional ultrasound for nuchal translucency measurement in early pregnancy

To evaluate the role of three dimensional ultrasound in Nuchal translucency measurement in the first trimester. Prospective cross sectional study. Forty eight women pregnant in their first trimester were subjected to conventional and there dimensional ultrasound examination by two sonographers at a time using Vulson 730 machine. Scanning was saved and re-evaluated for nuchal translucency measurement. There was a good agreement between two and three dimensional altrasound. There was a positive correlation between nuchal thickness [NT] and crown rump length [CRI] [p<0.01]. There were negligible clinical differences in measurements of NT and CRL between the different observers. Only two cases had NT = 6 mm and both aborted. Nuchal translucency measurement is feasible, safe and accurate. This technique is potentially useful in fetuses that are not in all optimal position for standard 2D nuchal translucency measurement

Ginseng induced gross malformations in albino mice in vivo

It is generally believed that herbal medicines are safer to use during pregnancy than the conventional. Herbal therapies have been recently reported to be associated with toxic effects in vitro, including teratogenic. There is paucity of evidence regarding effects of Geinseng on developing concepts in experimental animals. The present work was, therefore, designed using albino mice; these were given Panax ginseng root powder throughout pregnancy, the dams were sacrificed on 18th day of gestation and foetuses were delivered. Gross malformations were evident in the treated groups and were found to be statistically significant [P< 0.05] and dose dependent, being more pronounced in the high dose treated group as compared to the low dose treated or the control group. Previous studies have shown that different monomers of gin senosides have teratogenic effects in vitro; we adjoin by concluding that ginsenosides present in the commercially available Ginseng products have teratogenic effects in vivo as well

Study of accuracy of commonly used fetal parameters for estimation of gestational age.

Estimation of the gestational age by sonographic measurements of fetal parameters is usually done by measuring mean sac diameter (MSD), Crown-rump length (CRL), biparietal diameter (BPD), head circumference (HC), femoral length (FL) and abdominal circumference (AC) depending on the trimester of pregnancy. This is a prospective study to see the correlation of different fetal parameters in estimating the gestational age. A total of 71 normal women were taken and ultrasonogram was done to take MSD and CRL in 1st trimester and BPD, HC, FL and AC in 2nd and 3rd trimester. Gestational age was calculated by MSD using Rempen normogram and Hadlock normograms were used for the rest of fetal parameters. Gestational age by LMP was also calculated at the same time. Correlation of different fetal parameters in estimating gestational age in different trimesters was done by Pearson correlation. Pearson correlation showed that the CRL was the best fetal parameter (correlation coefficient of 0.909) in the first trimester. The correlation of MSD and average gestational age by MSD and CRL was with correlation coefficients of 0.778 and 0.888 respectively. Thus the averaging of gestational age in 1st trimester decreases the accuracy in the gestational age estimation. Correlation of gestational age by BPD, HC, FL and AC and their average in 2nd trimester showed that the best correlation was by AC and the least correlation by BPD in this study. It is in contrary to other studies which could be due to chance finding or bias because of prospective study. Pearson correlation calculated in 3rd trimester showed HC and FL were better parameters than BPD and AC. Average gestational age by simple averaging of BPD, HC, FL and AC gives more accurate estimation of gestational age in both 2nd and 3rd trimester.