ABSTRACT
To differentiate pregnancies complicated by oligohydramnios due to intrauterine growth retardation from those due to renal agenesis, the authors administered furosemide intravenously to eight pregnant women (19-25 weeks gestation) with oligohydramnios. The fetal abdomen was scanned with ultrasound to demonstrate the fetal urinary bladder. In six fetuses, sonography failed to demonstrate the bladder: two fetuses had growth retardation with normal kidneys and bladder, and four had renal anomalies. It is concluded that administration of furosemide to the mother fails to induce diuresis in growth-retarded fetuses of 19-23 weeks gestation and that failure to see the fetal bladder after furosemide administration does not necessarily indicate absent fetal kidneys.
Subject(s)
Amniotic Fluid , Fetal Diseases/diagnosis , Fetal Growth Retardation/diagnosis , Furosemide , Kidney/abnormalities , Pregnancy Complications , Ultrasonography , Diagnosis, Differential , Diuresis/drug effects , Female , Fetal Diseases/complications , Fetal Growth Retardation/complications , Humans , Kidney/pathology , Pregnancy , Urinary Bladder/pathologyABSTRACT
The prenatal diagnosis and postpartum confirmation of hydranencephaly is discussed. The need for an adequate knowledge of fetal cranial anatomy when performing obstetric sonography is stressed.
Subject(s)
Anencephaly/diagnosis , Hydranencephaly/diagnosis , Ultrasonography , Adult , Female , Humans , Infant, Newborn , Pregnancy , Prenatal DiagnosisABSTRACT
Doppler blood velocity waveforms were analyzed from the umbilical artery as an indication of fetal well-being. Since the ratio of systolic to diastolic peak flows (A/B) reflects placental vascular resistance, an abnormality of this value may accurately predict compromised fetuses. Twenty-one studies were performed on 13 patients, using a new duplex system for real-time imaging and range-gated pulsed Doppler analysis, and compared to normal standards. Thirteen studies done in nine uneventful pregnancies were consistently normal. However, abnormal studies were found in the four patients reported as case histories, including women with sickle cell anemia, systemic lupus, diabetes, and growth retardation. The A/B ratio was felt to have predicted potential fetal compromise, including the two fetal deaths. Therefore, with certain cautions, we feel that this rapid, non-invasive technique is useful as a serially applicable reflector of the status of fetoplacental circulation.
Subject(s)
Blood Flow Velocity , Fetal Diseases/diagnosis , Prenatal Diagnosis , Ultrasonography , Umbilical Arteries/physiopathology , Adult , Female , Humans , Placenta/physiopathology , PregnancyABSTRACT
Real time ultrasound was used to evaluate the anatomy of the fetal brain at different gestational ages. Anatomical correlation with the gross brain was utilized for more accurate identification of the neuroanatomical structures. The normal growth of the ventricular system was studied. Transaxial measurements of the anterior horn (AH) and maximum ventricular length (MVL) and width (MVW) were made, and enlarged as pregnancy progressed. The ratios of MVW/MVL, MVL/BPD, and MVW/BPD provide guides to the early diagnosis of hydrocephalus and intracranial abnormalities. Specific measurements of the cerebral ventricles at various gestational ages may be made accurately by utilizing the anatomical landmarks. The anterior horn and midbrain measurements are of little value in the early diagnosis of hydrocephaly. Maximum ventricular length and width are the most useful determinants of hydrocephaly, even as early as 20 weeks. A set of discordant twins in which twin B was found to be hydrocephalic by these studies in the twentieth week is presented with serial measurements for both twins. Multiple measurements of the cerebral ventricular system in utero permit early and precise diagnosis of fetal hydrocephaly.
