Gen Haba

Effect of antithyroid drug on chick embryos during the last week of development: delayed hatching and decreased cerebellar acetylcholinesterase activity.

Aim:  Hypothyroid state during embryogenesis disturbs normal growth and brain development, influencing later life. To evaluate the harmful consequences of the state during embryogenesis using an animal model, we inhibited thyroid hormone biosynthesis in chick embryos by using methimazole (MMI).

OP18.08: FGR fetuses have less facial expressions than AGA counterparts with the assessment by four-dimensional high-definition live (4D HDlive) ultrasound

only moderate decrease until 38 GW (108.2ml), but considerable variation of the absolute dimensions. The best fitting equation for SAS growth was a third-degree polynomial function (y = 433 – 59.6 * x + 2610 * x2 -33.36*x3; R2= 0.829). The relative SAS volume was high initially (40% in GW 16) and decreased until 23 GW (34%), peaked again at GW 27 (38%) and got reduced to 25% in GW 38. The best-fitting equation was a cubic function (y = 112-8.96*x+0.36*x2-0.00489*x3; R2 = 0.631). Conclusions: The SAS represents an important part of fetal intracranial anatomy, on average making up one third of the EV. Its reduction with advancing gestation may be considered a means to allow for further increase of brain volume until term, without concomitant increase in head size.

Progressive Fetal Subdural Hematoma Associated With Maternal Vitamin K Deficiency: Prenatal Diagnosis and Neurologically Favorable Prognosis

A 31-year-old woman, gravida 2, para 0, was referred to our hospital at 28 weeks’ gestation for an enlarged biparietal diameter in the fetus. Her first pregnancy had ended in artificial abortion at 11 weeks’ gestation for social reasons. She did not have any histories including anorexia or coagulation abnormality. She began to vomit frequently at 7 weeks’ gestation and was treated for hyperemesis gravidarum with infusion of nutrients. The nutritional solution contained multiple vitamins but not vitamin K. Because severe vomiting persisted, detailed examinations were performed. Upper gastrointestinal endoscopy at 25 weeks’ gestation revealed reflux esophagitis. She also had a diagnosis of mental disorders (attention deficit/hyperactivity disorder and anxiety disorder), and on-demand use of a major tranquilizer (risperidone) was started. At 28 weeks’ gestation, an enlarged biparietal diameter was noticed, and she was referred and admitted to our hospital. Fetal sonography revealed an enlarged biparietal diameter of 85.5 mm (14.0 standard deviation [SD]) caused by bilateral subdural hematoma (Figure 1A). As maternal serum protein induced by vitamin K absence or antagonist II (PIVKA-II) concentration, which was induced in the liver as a result of vitamin K absence, turned out to be 1.391 mAU/m (normal,< 40 mAU/mL), we highly suspected vitamin K deficiency and started its replacement therapy. There were not any other abnormal findings such as thrombopenia and coagulopathy (eg, low fibrinogen levels) in the maternal

Vesico-amniotic shunting for lower urinary tract obstruction in a fetus with VACTERL association†

Newborn cases of VACTERL association with lower urinary tract obstruction (LUTO) are rare and there have been no reports on those patients undergoing fetal therapy in English literature. We successfully performed vesico‐amniotic shunting in a fetus having LUTO caused by abnormality of the external genitalia at 16 weeks’ gestation. Although fetal karyotype was normal 46XY, follow‐up fetal ultrasound examinations revealed ventriculomegaly in the brain, a small stomach and a right multicystic dysplastic kidney. MRI at 31 weeks’ gestation suggested lobar type holoprosencephaly. Diagnosis of VACTERL association was confirmed postnatally. We consider that vesico‐amniotic shunting is indicated for a fetus of VACTERL association with LUTO if the parents wish the procedure after genetic counseling and explanations about the fetal conditions.