Uterine artery Doppler ultrasound in second pregnancy with previous elective cesarean section.

OBJECTIVES: To assess the effects of previous cesarean delivery (CD) and placental location on second trimester uterine artery Doppler indices in subsequent pregnancy and to assess the predictive values of abnormal Doppler findings for adverse pregnancy outcomes in women with previous CD. STUDY DESIGN: This prospective cohort study evaluated 400 gravida two pregnant women (200 with previous none medically indicated CD and 200 with previous normal vaginal deliveries (NVD)) who were referred for second trimester fetal anatomic survey. Uterine artery Doppler studies were performed in all participants who were then followed until delivery. RESULTS: Compared with women having prior NVD, women with prior CD had significantly higher rates of abnormal uterine artery pulsatility index (PI) (p < .001), and significantly more adverse pregnancy outcomes (p = .01). Among women with previous CD, all the measured adverse pregnancy outcomes occurred significantly more often in women with abnormal uterine artery Doppler indices (p < .001). CONCLUSIONS: CD seems to be associated with increased risks of impaired placental function and circulation and adverse pregnancy outcomes in the subsequent pregnancy, particularly in women with anteriorly located placenta near the previous uterine scar.

A case of prenatally detected left isomerism and hemiazygos continuation of inferior vena cava.

Heterotaxy syndromes are defined as the disorders that involve abnormal arrangement of viscera. We present a case of prenatally diagnosed left isomerism in a 30-year-old primigravida woman referred to our hospital for complex cardiac abnormality. Sonographic findings included heart block, unbalanced atrioventricular septal defect, interruption of the inferior vena cava with hemiazygos continuation, double superior vena cava, a right-sided stomach, and biliary atresia. The hemiazygos vein drained into the right atrium by the persistent left superior vena cava. This type of inferior vena cava interruption and continuation is rarely reported in prenatally detected cases of left isomerism. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:430-433, 2017.

Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography.

BACKGROUND: Coronary artery anomalies are not common, but could be very serious. OBJECTIVES: This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT). PATIENTS AND METHODS: The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists. RESULTS: Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%). Eighty-three subjects (3.1%) showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA) were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA), left circumflex artery (LCx), left anterior descending artery (LAD), posterior descending artery (PDA) and obtuse marginal (OM) artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%. CONCLUSION: Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging.