A new method for on-screen ultrasonographic determination of fetal cardiac axis.

OBJECTIVE: Our purpose was to develop an ultrasonographic method of using multiple electronic calipers for on-screen measurement of fetal cardiac axis. STUDY DESIGN: Two hundred low-risk patients who were seen for antenatal ultrasonography were studied. Standard biometry, anatomic survey, and echocardiography were performed on all fetuses. By use of a four-chamber view fetal cardiac axis was measured with electronic calipers. A table, derived from a trigonometric formula, was created to convert the caliper measurements to cardiac axis in degrees. The results were compared with a protractor-determined fetal cardiac axis. RESULTS: All echocardiograms had normal results. Fetal cardiac axis (+/- 2 SD) by the ultrasonographic method was 43 degrees (+/- 16 degrees) versus 43 degrees (+/- 14 degrees) by the protractor method. This difference was not significant. CONCLUSION: An on-screen method to determine fetal cardiac axis by use of multiple calipers is described. It is comparable to a protractor-measured fetal cardiac axis.

Gender-specific second-trimester biometry.

OBJECTIVE: This study was designed to evaluate the significance of gender differences for commonly used biometric parameters obtained ultrasonographically from second-trimester euploid fetuses. STUDY DESIGN: Gender-specific linear regression equations were developed for gestational age dependent and independent biometry from second-trimester ultrasonographically normal singleton euploid fetuses by use of biparietal diameters and femur and humerus lengths. Regression lines for male fetuses were compared with those for females by determining overlap of 95% confidence intervals at specific points. RESULTS: A total of 288 male fetuses (mean gestational age 16.7 +/- 1.0 weeks) and 251 female fetuses (mean gestational age 16.8 +/- 1.2 weeks) (not significant) were evaluated. Small statistically significant gender differences in fetal biometry were identified. The largest gender difference for gestational age-dependent parameters was a biparietal diameter difference of 1.15 mm at 21 weeks. The largest gender difference for gestational age-independent parameters was a femur length difference of 1.7 mm at a biparietal diameter of 50 mm. CONCLUSION: Statistically, but not clinically, significant gender differences of small magnitude exist for second-trimester fetal biometry, suggesting that gender-specific nomograms may be of limited value.

Prenatal diagnosis of cleidocranial dysostosis.

BACKGROUND: Cleidocranial dysostosis is an autosomal dominant disorder characterized by absent or hypoplastic clavicles and dysplasia of the osseous tissue in the cranium. CASE: We describe the prenatal diagnosis and neonatal evaluation of cleidocranial dysostosis in the pregnancy of a woman also affected with this disorder. CONCLUSION: The sonographic appearance of absent or hypoplastic clavicles, in the absence of other findings suggesting a skeletal dysplasia, strongly suggests the diagnosis of cleidocranial dysostosis. Nomograms are available to follow the growth and development of normal clavicles. Assessment of normal long-bone growth in relation to clavicular size may aid in the diagnosis.

Congenital complete heart block associated with maternal anti-Ro antibody: a case report.

The presence of anti-Ro antibody in maternal serum is a serologic marker for increased risk of the development of congenital complete heart block in the fetus. Current etiology and evaluation of these mothers and their fetuses are examined. A case report is presented.