Biomedical subjects
Publications and source records attributed to P W Verco.
Unequivocal narrowing of the anterior cranium, with an apparent constriction in the approximate region of the coronal sutures, in the absence of oligohydramnios is presented as a warning sign of spina bifida in the second trimester fetus. It makes detailed assessment of the spine, cerebellum, and other ultrasonographic features imperative and may justify amniocentesis.
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Thirty-five multiple and 168 singleton fetal weight estimations were made in an Australian population using the tables of Warsof et al., which have been computed from a North American population. The estimated fetal weights were compared to the actual birth weights within 96 h of estimation. Correlation coefficients of the actual birth weight with the estimated fetal weight for the total group, singleton and multiple pregnancies respectively, were 0.967, 0.969 and 0.933. The percentages of estimated fetal weights falling within 10% of the actual birth weight were for the three groups, 79.3%, 77.9% and 85.7% respectively. Individual weight sub-groups, less than 1500 g, 1500-2500 g, 2500-4000 g and greater than 4000 g, showed correlation coefficients of 0.84, 0.838, 0.839 and 0.759 respectively, which compare favourably to published studies of North American populations using this method. It is concluded that ultrasonic fetal weight estimation using the North American computerized tables of Warsof et al. is appropriate for an Australian population and is valid for both singleton and multiple pregnancies.
Twenty-one cases of fetal urinary tract abnormalities were detected on maternal ultrasound in a 5 year period. Six fetuses died and 13 of the 15 surviving cases have had corrective urological surgery, usually during the neonatal period. Maternal ultrasound provides advanced warning of major urinary tract abnormalities in the newborn. Therefore, appropriate investigations and medical management can be instituted early and potentially destructive urological lesions can be corrected as soon as possible. As yet, antenatal intervention does not seem to be warranted as the most common cause of bilateral upper tract dilatation in the surviving cases in this series was primary reflux, and in the cases that died the urinary abnormalities were not salvagable.
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The accuracy of 2 methods of antenatal ultrasonic fetal weight estimation has been compared. The method of Warsof et al. (1977) computes the estimated fetal weight from measurements of the abdominal circumference and the biparietal diameter, whilst the method of Higginbottom et al. (1975) utilises the circumference of the abdomen alone. The estimated weights obtained by the 2 methods were compared with the actual weights at birth occurring within 48 hours of the estimation. Using the tables of Warsof et al., 77% of the actual birth weights were within 10% of the estimated weight, with a coefficient of correlation of 0.95. Eighty-two per cent of babies less than 2,500 g fell within 10% of the estimated weight (Warsof et al.), with a coefficient of correlation of 0.96. Using the formula of Higginbottom et al., 56% of the total birth weights fell within 10% of the estimated weight and the coefficient of correlation was 0.89. Forty-five per cent. of the babies weighing less than 2,500 g were within the 10% range, the coefficient of correlation of this subgroup being 0.91. It is concluded that antenatal fetal weight estimation using the computed tables of Warsof et al. is superior in our population to the method described by Higginbottom et al., and such antenatal fetal weight estimation is of potential value in many high risk pregnancies.
A case is described of an early cervical pregnancy in a 30-year-old patient following curettage 6 months previously for an inevitable abortion. The condition was managed initially by suction aspiration, but further curettage with circumsuture of the cervix was required for delayed haemorrhage. The condition was suspected at laparoscopy and confirmed by ultrasonic scan. Laparoscopy indicated that the gestation sac was below the level of the uterine vessels, and was thus of prognostic as well as diagnostic value.
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