First trimester umbilical cord and vitelline duct measurements using virtual reality.

BACKGROUND: the umbilical cord and vitelline duct are of vital importance to the fetus, but they are rarely the subject of first trimester two-dimensional (2D) ultrasound evaluation due to the complexity of their shape and morphology. Virtual reality (VR) allows efficient visualisation and measurement of complex structures like the umbilical cord and vitelline duct. AIM: to measure normal first trimester human growth of the umbilical cord length (UCL) and vitelline duct length (VDL) using a VR system; and to correlate both measurements with the gestational age (GA) and crown-rump length (CRL) and the VDL with the yolk sac volume (YSV). STUDY DESIGN: prospective cohort study. Serial three-dimensional (3D) ultrasound measurements were performed from six to 14weeks GA, resulting in 125 3D volumes. These volumes were analysed using an I-Space VR system. SUBJECTS: Thirty-two healthy pregnant women with an ongoing, normal pregnancy. OUTCOME MEASURES: the UCL, VDL, YSV and other related structures were measured. RESULTS: The UCL, measurable in 55% of cases, was positively correlated to advancing GA and CRL (p<0.001). The VDL could be measured in 42% of cases and showed a positive relationship with GA and CRL (p<0.001). There was a significant (p<0.001) relationship between YSV and VDL. CONCLUSIONS: the present study, facilitated by a VR system, is the first to provide an in-vivo longitudinal description of normal first trimester growth of the human umbilical cord and vitelline duct. Further studies will reveal whether these parameters can be used in detection of abnormal fetal development.

Emergence of a glomus-like body in the human yolk sac: a microanatomical analysis of its structure.

Since the last decade the Yolk sac (YS) has been a topic of increasing interest due to the growing use of high-resolution sonography in early determination of pregnancy. Human YS shape and diameter are indicators of viability of pregnancy during the early embryonic period. Nevertheless, the major interest concerns the vital function it plays in early embryo growth and development. Two compartments are recognized in this organ: the yolk sac proper and the vitelline stalk. In this study we report the identification and partial characterization of a glomus-like body in the wall of the secondary YS in humans. A detailed structural description is also presented on the time course of formation of this new structure, at precisely sequential stages between 4-8 wk post-conception. The significance of this new compartment on the YS function is analyzed. Light and scanning electron microscopy were used to investigate the microstructure of the YS and the vitelline stalk during the first 8 wk of development. Ten YSs were collected from embryos (aged between 24-50 days) obtained from emergency salpingectomies due to tubal ectopic pregnancy. From 5 wk onward a new structure was observed in the YS located near the apex of the pear-shaped yolk vesicle and closed to the connecting stalk. We designate this differentiation as glomus-like body. This structure is 1-1.5 mm long and merged from a pocket-like structure of the extraembryonic splanchnic mesoderm of the YS wall. It likely represents an area of convergence of the vascular network of the YS wall. Our findings underline the remarkable complexity of the human secondary yolk sac during early development. The detailed description of the microanatomy of this vital organ is of theoretical and practical interest in order to unravel the mechanisms used by the yolk sac to transport nutrients to the embryo.

Development of the vitellaria of the liver fluke, Fasciola hepatica in the rat host.

The development of the vitellaria of Fasciola hepatica within the liver of its rat host was studied by means of whole-mount stained preparations and transmission electron microscopy, together with light and electron immunocytochemistry using an antibody to vitelline protein B, an eggshell precursor protein synthesized by F. hepatica. No vitelline cells could be identified in flukes recovered from the liver parenchyma, by any of the methods used. In contrast, follicles were present in flukes at the earliest time of recovery from the bile duct, namely, 5 weeks 3 days post-infection. The vitellaria in these flukes formed a row of small follicles on either side of the body. Development of the follicles was rapid: by 6 weeks 3 days, the vitellaria resembled those in the adult fluke and eggs were present in the uterus. Immunolabelling was confined to the shell protein globules in the vitelline cells, confirming the packaging of the eggshell protein within the shell globule clusters.