Relationship between placental localisation, birth weight, umbilical Doppler parameters, and foetal sex.

BACKGROUND/AIM: The aim of this study is to examine the relationship between placental localisation, birth weight, and foetal sex. It also evaluates umbilical artery Doppler parameters and their relationship with placental localisation. MATERIALS AND METHODS: This is a retrospective study of 500 healthy pregnant women who gave birth at our university. All women had undergone a detailed ultrasound and Doppler examination at 20-23 weeks. The ultrasonography results of the patients were examined retrospectively. Foetal biometry, birth weight, and umbilical artery Doppler parameters were recorded and compared according to placental localisation. RESULTS: Birth weight was significantly higher in foetuses with anteriorly located placenta. The incidence of female foetuses was higher (62%) in relation to anteriorly located placentas, whereas male incidence was higher (51.9%) in relation to posterior placentas. A comparison of Doppler parameters betiveen groups revealed significantly higher pulsatility index (PI) and resistance index (RI) values in posteriorly located placentas. CONCLUSION: Foetal sex might affect placental localisation. Doppler parameters and birth weight might also differ according to placental side. These factors should be taken into consideration during the evaluation of obstetric patients.

Fetal cervical neuroblastoma: prenatal diagnosis.

Neuroblastoma is the most frequent extracranial solid tumor in childhood, but it is seldom diagnosed prenatally. It usually presented with adrenal masses. Presentation of other localization is extremely rare. We report a case of cervical neuroblastoma identified at 20 weeks of gestational age. This is the third case diagnosed antenatally on neck region in the literature. Additionally, it is the first case that extended to the brain. We also discussed the literature for cervical neuroblastoma detected prenatally.

Spontaneous rupture of the renal pelvis caused by calculus: a case report.

Rupture of the urinary collecting system associated with peripelvic extravasation of the urine is an unusual condition and commonly associated with obstructing calculus. We report a patient, recently given chemotherapy due to lymphoma, with acute abdomen symptoms. He had a renal pelvis rupture with perirenal extravasation of urine, an uncommon condition due to a stone in the ureter. Diagnosis was suspected on serial ultrasonography, and confirmed by computed tomograhy. Diagnosis, follow-up, and therapeutic approach are discussed.

The cisterna magna size in normal second-trimester fetuses.

OBJECTIVE: The purpose of this study was to evaluate cisterna magna size of the fetuses between 16 and 24 weeks of gestation, and to establish a normogram for cisterna magna measurements during gestation. METHODS: A prospective study of normal singleton pregnancies was established. Measurement of the fetal cisterna magna was performed by transabdominal ultrasonography between 16 and 24 weeks of gestation in 194 fetuses. RESULTS: A linear correlation was obtained between gestational age (GA) and cisterna magna (R(2)=0.75, P<0.0001). A linear correlation was also found between biparietal diameter and cisterna magna (R(2)=0.74, P<0.0001). The normal mean (+/-SD) for each gestational week was defined. CONCLUSION: The present data offer the normal range of the cisterna magna. Cisterna magna measurement may provide normative data for fetal growth and development. Abnormal measurement of cisterna magna may be a clue for posterior fossa pathologies or a chromosomal disorder.

Short saphenous vein incompetence and chronic lower extremity venous disease.

OBJECTIVE: We performed this prospective study on patients with signs and symptoms of chronic venous disease to emphasize short saphenous vein (SSV) insufficiency, which is not routinely evaluated with Doppler ultrasonography in every center. METHODS: One hundred seventy-eight patients with signs and symptoms of chronic venous disease were included in the study. We used the CEAP (clinical, etiologic, anatomic, and pathophysiologic data) classification in evaluation of the limbs with isolated and nonisolated SSV incompetence. Patients were classified according to age, occupation, body mass index, and associated chronic illness. A chi(2) test and a t test were used in the statistical analysis. RESULTS: Reflux was observed in 190 (53%) of 356 limbs. In 11 limbs, isolated SSV reflux was observed. These 11 limbs were classified as CEAP grade 2 (3 limbs), CEAP grade 3 (3 limbs), and CEAP grade 4 (5 limbs). Short saphenous vein reflux was observed in 21 (5.9%) of 356 limbs. Mean SSV diameters were 3.89 mm (range, 1-11 mm) on the right and 4.03 mm (1.3-10 mm) on the left. CONCLUSIONS: No statistical significance was found between age, sex, body mass index, occupation, and associated chronic disease and deep or superficial venous system incompetence. A statistically significant difference was found between the SSV diameter of the limbs and associated venous incompetence.

The relation between pelvic varicose veins, chronic pelvic pain and lower extremity venous insufficiency in women.

PURPOSE: To determine the frequency of pelvic varicose veins with transvaginal ultrasound and associated lower extremity venous insufficiency with Doppler ultrasound in women with chronic pelvic pain of undetermined origin. MATERIALS AND METHODS: A total of 100 women with chronic pelvic pain of undetermined origin lasting more than 6 months were included in the study. The presence of anechogenic and non-pulsatile vascular structures demonstrating flow in Doppler ultrasound with a diameter > 5 mm in parauterine and paraovarian localizations was accepted as pelvic varicose veins. In all patients, lower extremity venous systems were examined with Doppler ultrasound to assess possible associated venous insufficiency. Chi-square test was used for statistical analysis. RESULTS: Pelvic varicose veins were discovered with transvaginal ultrasound in 30 of 100 patients. This association was shown to be statistically significant. Various degrees of associated lower extremity venous insufficiency were also discovered in 21 of these 30 patients. CONCLUSION: This study has shown that the presence of pelvic varicose veins in women with chronic pelvic pain is not infrequent, and in the majority of cases, they are associated with lower extremity venous insufficiency. Since the diagnosis of lower extremity venous insufficiency plays an important part in deciding the course of treatment, lower extremity Doppler ultrasound must be included in the evaluation when pelvic varicose veins are discovered.

Ultrasonography of the calcaneus in Sever's disease.

Severs disease (calcaneal apophysitis) is a self-limiting condition seen in physically active children. Although there is controversy about the radiographic appearance, some reports propose the importance of fragmentation of the secondary nucleus in the diagnosis of Severs disease. We studied secondary nucleus of the calcaneus with ultrasonography. Twenty-one symptomatic heels of 14 children were examined. All these heels showed fragmentation of the secondary nucleus on both conventional radiograph and sonography. Ultrasonographic examination also showed 2 retrocalcaneal bursitis. Our initial data showed that sonography may be valuable in the diagnosis of Severs disease.

Ultrasound evaluation of the normal fetal pharynx.

OBJECTIVE: To obtain normative data for fetal pharyngeal diameter and to investigate the ability to visualize pharynx at different gestational ages during routine prenatal sonography. METHODS: Sonographic studies were performed in 292 consecutive pregnant women. The diameters of the pharynx were measured and our ability to visualize pharynx was evaluated at different gestational ages. RESULTS: Sonographic measurements of the pharyngeal diameter were obtained in 153 of the 292 fetuses. The diameter of the pharynx increased from a mean of 4.5+/-0.53 mm at 16 weeks to 9.1+/-1.72 mm at 36 weeks. Pharyngeal diameters showed a significant positive relationship with advancing gestational age (p<0.0001, R2=0.571). The differences in visualization among different gestational age groups were found to be significant (p<0.05 by Chi-Square). CONCLUSION: This study reports normative data for fetal pharyngeal diameter. Pharyngeal measurements were similar to previous reports in the literature. Our success in visualizing the pharynx was best between 21 and 30 weeks of gestation. This period might be the optimum time for evaluating fetal pharynx.

Endobronchial myofibroblastic sarcoma presenting with hemoptysis in a patient with a normal chest x-ray.

Hemoptysis is an important symptom in clinical practice. The diagnosis of the underlying cause is often difficult, particularly in patients presenting with a normal chest x-ray. We report a case of hemoptysis with a normal chest x-ray due to a rare endobronchial neoplasm: myofibroblastic sarcoma.

Psoas abscess twenty-one years after ipsilateral nephrectomy.

We report an unusual case of psoas abscess, which developed twenty-one years after ipsilateral nephrectomy and was caused by infrequent pathogen, Proteus mirabilis. It was diagnosed by computed tomography and was drained percutaneously with a nephrostomy tube guided by ultrasonography.