Color Doppler aided prenatal diagnosis of a type 1 cystic sacrococcygeal teratoma simulating a meningomyelocele.

Type 1 cystic sacrococcygeal teratomas, usually associated with good outcome following neonatal resection, must be differentiated at the time of prenatal diagnosis from sonographically similar meningomyeloceles, which carry a grave prognosis. We present an unusual case in which color Doppler imaging assisted correct midtrimester prenatal diagnosis of a large type 1 cystic sacrococcygeal teratoma closely simulating a meningomyelocele.

Alterations in ventricular filling in small-for-gestational-age fetuses.

OBJECTIVE: This study was designed to evaluate if fetal diastolic cardiac function is compromised in small-for-gestational-age (SGA) fetuses with documented fetal well-being at the biophysical profile. STUDY DESIGN: We have compared indices of diastolic cardiac flow in singleton SGA fetuses with forward diastolic flow in the umbilical artery at Doppler velocimetry and documented fetal well-being (n = 10) with those of appropriate-for-gestational-age (AGA) controls with documented fetal well-being matched for gestational age at ultrasound (n = 20). RESULTS: At the mitral valve, velocity time integral (VTI) (0.059+/-0.011 vs. 0.069+/-0.011 m, p = 0.04), peak velocity of the A wave (0.426+/-0.043 vs. 0.498+/-0.087 m/s, p = 0.005), and acceleration time of the E wave (0.046+/-0.004 vs. 0.053+/-0.007 s, p = 0.008) were significantly different between SGA and AGA fetuses. At the right atrioventricular valve, only VTI was significantly different between SGA and AGA fetuses (0.065+/-0.014 vs. 0.078+/-0.011, p = 0.03). CONCLUSIONS: These findings suggest that SGA fetuses have significantly lower left and right ventricular diastolic filling compared with AGA fetuses without significant changes in diastolic function.

Prenatal ultrasonographic assessment of the ductus venosus: a review.

OBJECTIVE: To review current data pertaining to prenatal ultrasonography of the ductus venosus. DATA SOURCES: We identified English-language studies regarding prenatal ultrasonography and the fetal ductus venosus. The studies were obtained from a MEDLINE search for the period 1966 through March 1996. Additional sources were identified through cross-referencing. METHODS OF STUDY SELECTION: We reviewed all published reports, case studies, and articles regarding ultrasonographic morphology, physiology, and pathophysiology of the fetal ductus venosus. TABULATION, INTEGRATION, AND RESULTS: Knowledge of the function of the fetal ductus venosus in both normal and abnormal fetal conditions is increased by prenatal ultrasonographic data. Altered ductus venosus hemodynamics may be noted in various medical conditions that include fetal growth restriction, twin-twin transfusion, invasive diagnostic procedures (chorionic villus sampling and fetal blood sampling), fetal anemia and transfusion, complex cardiac structural anomalies, and cardiac arrhythmias. CONCLUSION: Blood flow velocity in the fetal ductus venosus reflects the pressure gradient between the umbilical vein and the cardiac atria. Knowledge of pathophysiologic hemodynamic changes of blood flow in this vessel obtainable by prenatal ultrasonography in conjunction with fetal disease may assist diagnosis and management.

Mid-trimester prenatal sonographic diagnosis of a pericardial cyst.

Prenatal diagnosis of pericardial masses are infrequent and usually consist of intrapericardial teratomas or haemangiomas. We present the first report of prenatal diagnosis of a suspected pericardial cyst at 14 weeks' gestation which was subsequently confirmed by neonatal computed tomography.