Impaired Elastic Properties of the Ascending Aorta in Fetuses With Coarctation of the Aorta.

Background Abnormal aortic elastic properties are major notable vasculopathy involved in coarctation of the aorta (CoA). However, there are no reports on aortic wall elastic characteristics in fetuses with CoA. Methods and Results Fifty-six fetuses with CoA and 56 normal controls were included in this prospective case-control study. The dimensions of the cardiac chamber, the size of the aorta, left ventricular myocardial performance indexes, and aortic elastic properties, including the global circumferential strain, fractional area change and mean longitudinal strain, were measured serially in utero. The global circumferential strain, fractional area change, and mean longitudinal strain in fetuses with CoA were smaller than those in the normal group at both the first and last examinations (18.50% versus 37.73% for global circumferential strain, 38.90% versus 57.55% for fractional area change, 6.61% versus 11.81% for mean longitudinal strain at first scan, 16.62% versus 42.05% for global circumferential strain, 36.54% versus 59.7% for fractional area change, 6.2% versus 11.46% for mean longitudinal strain at last scan, all P<0.001). There were negative correlations between aortic elastic properties and left ventricular myocardial performance indexes in fetuses with CoA (P<0.01). Aortic elastic properties were correlated positively with aortic isthmus size in fetuses with CoA (P<0.01). Conclusions Aortic strain and the fractional area change were decreased in fetuses with CoA. Impairments of these aortic elastic properties were associated with diminished heart function and aortic isthmus size in utero. Further large-scale longitudinal studies are required to confirm the potential predictive value of cardiovascular morbidity (ie, hypertension) in fetuses with CoA.

A Fetus with 17q23.1-q23.2 Microdeletion Presents with Primary Bilateral Lung Hypoplasia in Utero.

Background:Patients with 17q23.1-q23.2 microdeletion syndrome have common features, including mild to moderate developmental delay; microcephaly; heart defects; and hand, foot, and limb abnormalities. Case Report: We describe a fetus with 2.14 Mb microdeletion involving 17q23.1-q23.2 and presenting with primary bilateral lung hypoplasia in utero. The fetal biometry measurement and estimated fetal weight had a two-week delay but they were still above the 10th percentile. There were no other structural abnormalities. Primary lung hypoplasia is infrequent and has a poor prognosis, especially when bilateral. There are no reports of fetal survival with primary bilateral lung hypoplasia. Conclusion: This is the first report of the coexistence of primary lung hypoplasia and chromosome 17q23.1-q23.2 microdeletion detected during fetal life.

Type II Left Pulmonary Artery Sling Associated with Double-Outlet Right Ventricle Diagnosed by Fetal Echocardiography and Postnatal Computer Tomography.

INTRODUCTION: Left pulmonary artery sling (LPAS) is a rare congenital vascular anomaly which can be isolated or associated with other malformations. Patients with LPAS usually have symptoms of airway obstruction. CASE PRESENTATION: We present a case of LPAS with double-outlet right ventricle diagnosed by fetal echocardiography at 33 weeks' gestation. Postnatal computed tomography echocardiography confirmed the diagnosis. Additional bronchial bridge and left main bronchial stenosis found by computed tomography led to a diagnosis of type II LPAS. CONCLUSION: It is crucial to trace pulmonary artery branches in the prenatal diagnosis. Prenatal diagnosis of LPAS will facilitate postnatal care and timely treatment.

Cross-sectional reference values of cerebral ventricle for Chinese neonates born at 25-41 weeks of gestation.

To establish the cross-sectional reference values of cerebral ventricular size for the Chinese newborns by the most correlated explanatory variables. The anterior horn width (AHW), thalamo-occipital distance (TOD), and ventricular index (VI) were collected prospectively from 1- to 7-day neonates without potential neurological problems. All neonates were delivered or treated at the Hunan Provincial Maternal and Child Health Care Hospital or Second Xiangya Hospital of Central South University between February and August 2021. The most correlated explanatory variables were identified with the max-min normalization and multiple regression. The reference values were then established based on the above variables. Additionally, intraclass correlation coefficients (ICC) were applied to evaluate the reliability of the overall data collection process. This prospective study consisted of 1848 neonates. The AHW was most highly correlated with GA; the TOD and VI were most strongly correlated with birth weight. All the foregoing correlations were positive ones. Heteroscedasticity and influential points existed in both TOD and VI. The ICCAHW was the largest to a specific rater or between raters, the ICCTOD the second largest, and the ICCVI the smallest. CONCLUSIONS: We recommend using the GA-based AHW reference values and birth weight-based TOD and VI ones. We also present a comparison of GA-based upper limits from all available reference intervals. Moreover, we determine that measurement errors are the primary cause of influential points and heteroscedasticity in TOD and VI studies and infer that the studies of TOD and VI are vulnerable to them. WHAT IS KNOWN: • Reference values of infantile cerebral ventricles are vital in diagnosing and treating cerebral ventricular dilatation. • Precursors established gestational age-based reference values subjectively. WHAT IS NEW: • We set cross-sectional reference values based on the most correlated variables for Chinese neonates and compared all available gestational age-based upper limits. • Influential points and heteroscedasticity mainly caused by measurement errors are common in TOD and VI studies.

Z-score model of foetal ascending aorta diameter distensibility.

Objective: The purpose of this study is to establish Z-scores models of normal fetal ascending aorta diameter and diameter distensibility. Methods: The maximum systolic diameter (Dmax), minimum diastolic diameter (Dmin), and diameter distensibility of the sinotubular junction were measured and taken as dependent variables in 490 normal fetuses at 18-40 gestational weeks, and gestational age (GA), biparietal diameter (BPD), and femoral length (FL) were taken as independent variables. The data were subjected to regression analysis, and the best-fitting equations for the dependent variables based on the independent variables were determined. The fitting equations were then applied to construct the Z-scores models. Results: The Dmax, Dmin and Diameter Distensibility in normal fetuses between 18 and 40 weeks of GA could be evaluated by utilizing the Z-scores models. Dmax and Dmin increased significantly with increasing GA, BPD, and FL. Diameter distensibility, assessed as (Dmax-Dmin)/Dmin, decreased significantly with increasing GA, BPD, and FL. Conclusion: The Z-scores are valuable, and can be utilized as a potent supplement to the conventional approach as they can indirectly reflect the development of fetal ascending aortic elastic property.