Geoffrey Wong

Obstetric complications in patients with hereditary thrombophilia identified using the LCx microparticle enzyme immunoassay: a controlled study of 5,000 patients.

Factor V Leiden (FVL) and prothrombin (PT) G20210A mutations are associated with increased risk of deep venous thrombosis, pulmonary embolism, and obstetric complications. The development of inexpensive and reliable screening methods will assist in defining subpopulations of patients at risk who should undergo testing. We used a method, developed by Abbott Laboratories (Abbott Park, IL), to study 5,000 pregnant women and evaluated the association of obstetric complications with the presence of the FVL and PT G20210A mutations. We found a statistically significant association between FVL and stillbirth. There were also trends toward an association between FVL and placental abruption and between PT G20210A and intrauterine growth retardation. In addition, an association may exist between PT G20210A and preterm delivery for white women. All other parameters studied, including miscarriage and preeclampsia, did not show a statistically significant association with FVL or PT G20210A. These results confirm the association between genetic thrombophilia and selected obstetric complications.

Increased Systolic Peak Velocity in Fetal Middle Cerebral Artery Blood Flow Shown by Doppler Sonography in Acute Fetomaternal Hemorrhage

Doppler measurement of peak systolic velocity of fetal middle cerebral artery (MCA) blood flow provides a noninvasive method to assess the degree of anemia in fetuses with chronic anemia secondary to Rh alloimmunization or parvovirus infection. 1 - 8 There are 2 prior case reports of increased MCA peak systolic velocity in acute fetal anemia. 9 , 1 0 This report adds to that literature and stresses the importance of checking the MCA peak systolic velocity when acute fetal anemia is of concern to appropriately care for the anemic neonate at birth. In this case of a large fetomaternal hemorrhage, neonatal transfusion was set up at the time of the cesarean delivery because of the information gleaned from the MCA Doppler study.

Congenital pseudohypoaldosteronism presenting in utero with acute polyhydramnios

A case of acute polyhydramnios in a fetus with pseudohypoaldosteronism is presented. Although rare, metabolic causes for polyhydramnios should be considered when no obvious cause is found in workup of the pregnant woman and when structural survey of the fetus is normal.

Sonographic assessment of the cervix in pregnancy

Recent studies using transvaginal and transperineal sonography to monitor the cervix have dramatically increased our knowledge of morphological changes of the cervix throughout pregnancy. Knowledge of the normal and abnormal appearance of the cervix gives insight into the processes of premature labor and cervical incompetence. The finding of a short cervix can be used to identify (and possibly treat) patients at risk for premature delivery. This article reviews the use of cervical sonography in obstetric care, including the diagnosis of incompetent cervix, the detection and monitoring of premature labor, and the evaluation of placenta previa.

Fetuses With Trisomy 21 Having Conflicting Findings on Antenatal Testing for Fetal Well-being

This series reports 3 cases with conflicting antenatal sonographic findings: intrauterine growth restriction, absent or reversed end‐diastolic flow in umbilical artery Doppler imaging, and reassuring biophysical test results.

P03.10: Hand positions in fetuses with trisomy 18

Conclusions: Cornelia de Lange syndrome is a complex dysmorphic syndrome which can confer significant long-term morbidity. The gene for this condition has recently been identified and recognition of the sonographic features will help target prenatal investigations. The review presented here suggests that identification of forearm anomalies with oligodactyly combined with microcephaly and/or measurements ≤ 5th percentile with typical facial anomalies are findings that should arouse suspicion of this condition, although definitive diagnosis at present would have to await delivery.