Influence of maternal carbohydrate intake on fetal movements at 14 to 16 weeks of gestation.

OBJECTIVE: Ultrasonographic assessment of fetal movements at 14 to 16 weeks of gestation before and after maternal oral intake of carbohydrate. DESIGN: Thirty consecutive healthy pregnant women between 14 and 16 weeks of gestation were scanned transvaginally. Real-time ultrasound recordings of 20 min duration were performed in the fasting state and after an oral intake of 110 g of glucose. The number of fetal movements, body and limb movements and breathing movements were evaluated. Fetal movements were quantified using a digital chronometer, and the percentage of time spent moving and the rate of movements per minute were then calculated. Data was statistically analyzed using the simple and Wilcoxon paired t-test. RESULTS: Absolute number of fetal movements, body movements, rotation movements, time spent moving and rate of movements per minute showed a statistically significant increase after maternal intake of carbohydrate (p < 0.0001). CONCLUSIONS: Maternal oral intake of 110 g of carbohydrate significantly increases fetal movements at 14 to 16 weeks of gestation, thus allowing better ultrasonographic viewing of the fetus.

Ultrasonographic nomograms of the fetal fourth ventricle: additional tool for detecting abnormalities of the posterior fossa.

OBJECTIVE: To characterize normal growth of the fetal fourth ventricle on ultrasonography throughout pregnancy. METHODS: Consecutive biometric measurements and fetal organ scans were obtained from 299 patients undergoing fetal anatomic surveys between 13 and 40 weeks' gestation. Using 7- and 3.5-MHz transducers for early (13- to 17-week) and late (>17-week) examinations, respectively, we scanned the fetal head in the axial plane with special focus on the posterior fossa of the brain. The fourth ventricle was identified, and its anteroposterior diameter and width were measured. A "triangle" formula was used for calculating its circumference and area. RESULTS: The fourth ventricle was shown as a hypoechoic triangle below the level of the cerebellum. A linear regression line of the fourth ventricle was observed across gestational age, and a first-degree correlation was found between gestational age and anteroposterior diameter of the fourth ventricle (r = 0.894; P < .0001; y = -0.84 + 0.23 x gestational age), its width (r = 0.657; P < .0001; y = 3.82 + 0.14 x gestational age), its circumference (r = 0.843; P < .0001; y = 5.11 + 0.58 x gestational age), and its area (r = 0.844; P < .0001; y = -10.11 + 1.17 x gestational age). Twelve enlarged fourth ventricles were found between 14 and 16 weeks, but results of follow-up scans at 20 weeks were normal. CONCLUSIONS: An isolated enlarged fourth ventricle in the early second trimester might represent a normal variant; it should be followed, but decisions about the fate of the pregnancy should not be based solely on this finding.