Franca A. Gerards

Normal fetal lung volume measured with three-dimensional ultrasound.

To construct reference intervals for fetal lung volumes measured longitudinally using three‐dimensional (3D) ultrasound, and to evaluate the effect of gender on lung size.

Fetal lung volume: three-dimensional ultrasonography compared with magnetic resonance imaging

An accurate and reliable method for measuring fetal lung volumes would be helpful in predicting the outcome in cases with suspected impaired lung growth. Recent studies show that it is possible to obtain fetal lung volume estimations with magnetic resonance imaging (MRI) and three‐dimensional (3D) ultrasonography. The purpose of this study was to assess the agreement of lung volumes measured with 3D ultrasonography and MRI in uncomplicated pregnancies.

Predicting pulmonary hypoplasia with 2- or 3-dimensional ultrasonography in complicated pregnancies

OBJECTIVE The aim of this study was to compare 3-dimensional (3D) lung volume measurements with 2-dimensional (2D) biometric parameters in predicting pulmonary hypoplasia in complicated pregnancies. STUDY DESIGN In this prospective study, 1-4 scans of the fetal lungs were obtained in 33 pregnancies complicated by various disorders or complications with regard to pulmonary hypoplasia. The 3D lung volumes vs gestational age or estimated fetal weight, the thoracic circumference vs gestational age or femur length, the thoracic/abdominal circumference ratio, and the thoracic/heart area ratio were measured. RESULTS Of the 33 infants, 16 (48.5%) were diagnosed with pulmonary hypoplasia on postmortem examination or the clinical and radiological presentation. Three dimensional lung volume measurements had a better diagnostic accuracy for predicting pulmonary hypoplasia (sensitivity, 94%; specificity, 82%; positive predictive value [PPV], 83%; negative predictive value [NPV], 93%), compared with the best 2D biometric measurement thoracic/heart area ratio (sensitivity, 94%; specificity, 47%; PPV, 63%; NPV, 89%). CONCLUSION 3D lung volume measurements seem to be useful in predicting pulmonary hypoplasia prenatally.

Prenatal diagnosis of aneurysms of the vein of Galen (vena magna cerebri) with conventional sonography, three-dimensional sonography, and magnetic resonance imaging: report of 2 cases.

Objective. To describe the cases of 2 fetuses with aneurysms of the vein of Galen diagnosed prenatally. Methods. The techniques used were conventional sonography, three‐dimensional sonography, and ultrafast magnetic resonance imaging. On the basis of these imaging modalities, prognostic factors, such as drainage and secondary damage, were assessed. Results. The first fetus had good prognostic indices, and embolization after birth was successful. According to the prognostic factors, a poor neonatal outcome was predicted for the second fetus. The neonate died soon after birth. Conclusions. Conventional sonography, color Doppler imaging, and magnetic resonance imaging appeared to be useful diagnostic tools. The prognostic factors can be useful in counseling patients and providing the best possible care after birth.

Congenital diaphragmatic hernia: 2D lung area and 3D lung volume measurements of the contralateral lung to predict postnatal outcome.

Objectives: The aim of the study was to evaluate the prognostic utility of 2D lung area and 3D lung volume measurements of the contralateral lung in infants with congenital diaphragmatic hernia. Methods: At 18–37 weeks’ gestation between 1 and 5 scans of the contralateral fetal lung were obtained in 6 pregnancies complicated by congenital diaphragmatic hernia (5 left- and 1 right-sided). Lung volume measurements were compared with reference curves for gestational age and estimated fetal weight obtained from uncomplicated pregnancies. Lung area measurements were compared with reference nomograms. Results: Three infants survived and 3 died. Lung volume measurements versus gestational age were beneath the 5th percentile for the nonsurviving infants and within the normal ranges for the surviving infants. When comparing the observed/expected lung volume and lung area ratios of the first measurements with the ratios at the last visit before birth, the ratios of the infants who subsequently died decreased whereas the ratios of the infants who survived remained unchanged or increased. Conclusions: In the case of congenital diaphragmatic hernia, 3D lung volume measurements seem to be a good predictor of outcome but longitudinal measurement also provides important additional information. Larger studies are necessary to confirm these results.

Doppler Velocimetry of the Ductus Arteriosus in Normal Fetuses and Fetuses Suspected for Pulmonary Hypoplasia

Objective: The purpose of this study was to determine whether the pulsatility index (PI) of the ductus arteriosus could predict the occurrence of pulmonary hypoplasia secondary to congenital disorders or complications during pregnancy. Sample and Methods: In this longitudinal study, 78 uncomplicated pregnancies and 43 pregnancies complicated by various disorders or complications with regard to pulmonary hypoplasia were studied by Doppler sonography between 18 and 35 weeks of gestation. A PI >97.5th percentile was considered abnormal. Results: Using a multilevel modelling, the reference curve of the PI of the ductus arteriosus was created based on 301 measurements. Of the 43 complicated pregnancies, 21 infants (49%) were diagnosed with pulmonary hypoplasia on postmortem examination and/or the clinical and radiological presentation. Using the PI, a sensitivity of 38%, a specificity of 95%, a positive predictive value of 89% and a negative predictive value of 62% were found. Conclusion: The PI of the ductus arteriosus is not useful in predicting the occurrence of pulmonary hypoplasia secondary to congenital disorders or complications during pregnancy.

P04.23: 3-dimensional fetal lung volume measurements to predict pulmonary hypoplasia in pregnancies complicated by PROM

villi with trophoblastic proliferation though the villi in nonmolar abortions have less pronounced edema. Subchorionic hematoma is very common in early pregnancy may show various kinds of US findings from huge solid mass to multilocular cyst. Hematoma occurred shortly after dilatation and curettage of uterus for abortion may mimic pathologic condition as hydatidiform mole or invasive mole. Understanding of pathophysiology of the hydatidiform mole and various kinds of US findings of hydatidiform mole and molar mimicker can aid to the work-up and management of molar gestation to illustrate the various kinds of US findings of hydatidiform mole and molar mimicker as incomplete abortion, subchorionic hematoma and hematoma after dilatation and curettage of the uterus.

P04.22: Gender‐specific fetal lung volume measured with 3‐dimensional ultrasonography

villi with trophoblastic proliferation though the villi in nonmolar abortions have less pronounced edema. Subchorionic hematoma is very common in early pregnancy may show various kinds of US findings from huge solid mass to multilocular cyst. Hematoma occurred shortly after dilatation and curettage of uterus for abortion may mimic pathologic condition as hydatidiform mole or invasive mole. Understanding of pathophysiology of the hydatidiform mole and various kinds of US findings of hydatidiform mole and molar mimicker can aid to the work-up and management of molar gestation to illustrate the various kinds of US findings of hydatidiform mole and molar mimicker as incomplete abortion, subchorionic hematoma and hematoma after dilatation and curettage of the uterus.