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[Nuchal translucency measurement--an effective method for early recognition of fetal disease?].

BACKGROUND: In recent years, an increasing amount of experience has been collected in measuring the nuchal translucency (NT) of the fetus in early pregnancy. While all fetuses develop a measurable collection of fluid in the area of the neck between the 11th and 14th weeks of pregnancy, the fact that fetuses with chromosomal disorders, cardiac defects, and syndromal diseases, in particular, reveal an above-average incidence of increased NT has been noticed. OBJECTIVE: By processing our own patient data from the past two years, we intend to elucidate the question of whether NT measurement is a sensible investigation for the early detection of fetal problems. PATIENTS AND METHOD: NT measurements were carried out in 199 fetuses; these measurements were standardized according to the guidelines of the Foetal Medicine Foundation in London, in whose multicentric study we are participating. The patients were under the care of our prenatal diagnosis and therapy department and were referred to us from external sources. RESULTS: NT within the reference range was determined in 152 fetuses; NT exceeded the reference value in 47 fetuses. Of those fetuses with increased NT, 7 fetuses revealed a chromosomal anomaly, 1 foetus was suffering from a cardiac defect, 3 fetuses were suffering from other organ abnormalities, and 3 fetuses were determined to be suffering from syndromal disease. None of the fetuses whose NT measurements were within the reference range was discovered to be suffering from any of the above-mentioned problems. CONCLUSION: Even this relatively small group of patients reveals that NT measurement is a very effective filter for detecting certain fetal diseases during the early fetal period.

Abnormalities, Multiple↗
PubMed1997

Echogenic material in the fetal gallbladder and fetal disease.

The presence of echogenic material within the gallbladder is probably a rare finding in the fetus, and the list of predisposing factors known for postnatal life seems not to be applicable to prenatal diagnosis. In the present study 1656 obstetric scans were performed on referrals to the Unit of Fetal Medicine. No echogenic gallbladder contents were found before 28 weeks. In the subgroup of 523 fetuses who were examined during gestational weeks 28-42, six fetuses were found to have echogenic material in the gallbladder. The echogenicities were found in patients who had the following: extra-amniotic hematoma with intrauterine growth retardation and oligohydramnios, tetralogy of Fallot, trisomy 21 with atrioventricular septal defect and transient ascites, early abnormally distended fetal gallbladder, chromosomal aberration (translocation 10; 11) with bilateral clubfoot, and gastroschisis. Echogenic densities had disappeared at ultrasound scans performed during early postnatal life in four cases, were absent at five weeks in one case, and still present as calculi 8 months after birth in one case. Although no causative conclusions can be drawn from the report, these conditions are suggested as possible predisposing factors for the presence of echogenic material in the fetal gallbladder.

Adult↗
PubMed1978

Placental coccidioidomycosis without fetal disease.

We encountered two cases of maternal coccidioidomycosis with placental involvement. Altered cell-mediated immunity during pregnancy makes the diagnosis of desseminated coccidioidomycosis difficult by the routine serologic tests; placental examination provides specific information. A high index of suspicion regarding this disease and prompt institution of appropriate therapy are necessary in order to decrease maternal and neonatal mortality.

Adult↗