Prenatal diagnosis of choroid plexus papillomas of the lateral ventricle. A report of two cases.

Two cases of fetal choroid plexus papillomas diagnosed by ultrasound at 21 weeks of pregnancy are reported. Dilatation of the cerebral lateral ventricle, unilateral in one case, made it possible to see the irregular profile of the choroid plexus that was confirmed, successively, by magnetic resonance imaging and anatomic pathological examination on the aborted fetuses.

The diagnosis of benign uterine pathology using transvaginal endohysterosonography.

Twenty-nine women believed to be affected with benign uterine pathologies underwent transvaginal hysterosonography insertion of a physiological solution into the cervical cavity by means of a catheter positioned in the cervical canal. This new technique, due to the acoustic window created by the fluid, made it possible to find: one cervical polyp, six endometrial polyps, one endometrial synechia, five submucosa myomas and one uterine malformation, the presence of which, with traditional ultrasonography can only be suspected. The subsequent hysteroscopic check-up confirmed the high diagnostic reliability of hysterosonography which is also easy to carry out, safe and costs little.

Ultrasound diagnosis of heterotopic pregnancy with viable fetuses.

Combined pregnancy is an under-estimated and increasing clinical condition. Its recognition is usually made post-operatively. Ultrasound findings are not specific. Diagnosis is possible only when the cardiac activity of the extrauterine and intrauterine fetus can be detected. In the literature, 18 pre-operative sonographic demonstrations of such cases are reported. A correct echographic assessment can show a definite diagnosis or indicate a diagnostic laparoscopy minimizing maternal morbidity and mortality and improving the prognosis of the intrauterine fetus. In this report, ultrasound diagnostic aspects are discussed.

[Fetal choroid plexus cysts: a real dilemma!]. / Cisti dei plessi corioidei fetali: un vero dilemma!

The clinical significance of the fetal choroid plexus cysts, observed by prenatal sonographic examination, is now a days still discussed. A consequence of this situation is the discordance of opinions about the question of whether karyotype analysis is always necessary to evaluate chromosomal anomalies sometimes correlated, especially in the presence of (as some authors have reported) large (> 1 cm), bilateral, persistent cysts and of other structural abnormalities. We have effected a prospective study to estimate the incidence of fetal choroid plexus cysts and to establish the obstetrical behaviour to be adapted in these cases. During 834 routine ultrasonographic examinations at 18-21 weeks' gestational age, we have evaluated the presence of fetal choroid plexus cysts in 9 fetuses, with an incidence of 1.07%. Three of these cysts were larger than 1 cm, three were bilateral. Karyotype analysis, effected in all cases, diagnosed a case of Trisomy 18 in a fetus who ultrasonographically showed, in addition to a unilateral cyst of 1.2 cm, also a diaphragmatic hernia. Careful ultrasound follow-up revealed that all the cysts disappeared spontaneously, but two of them (whose dimensions were larger than 1 cm) were still visible at 24 weeks' gestation and probably this age will be too advanced to begin a chromosome analysis. In conclusion, we think that the presence of fetal choroid plexus cysts always imposes a careful ultrasonographic evaluation of fetal morphology and, since there is always the risk that other small fetal anomalies (evocative of abnormal fetal karyotypes) wight not be noted, we believe that it is better, in any case, to recommend to the patient a prenatal cytogenetical analysis.