P Jeanty

Fetal limb volume: a new parameter to assess fetal growth and nutrition.

Fetal growth and nutrition were evaluated using measurements of the subcutaneous tissues of the arm and leg to calculate limb volume. Arm measurements included transverse and anteroposterior arm thicknesses and subcutaneous tissue thickness; leg measurements included lengths and thicknesses of the humerus and femur, transverse and anteroposterior thigh thickness, and thigh subcutaneous tissue thickness. Volumes were calculated using equations with both circular and elliptical perimeters. Limb volume was found to be strongly correlated with gestational age, and may be a possible predictive factor of intrauterine growth retardation.

The value of adnexal sonographic findings in the diagnosis of ectopic pregnancy

A prospective study of 383 patients with suspected ectopic pregnancy was carried out at Yale-New Haven Hospital to determine the value of adnexal sonographic findings in the diagnosis of ectopic pregnancy. In patients with adnexal sonographic results and human chorionic gonadotropin titers less than 6000 mIU/ml (n = 220), the presence of a noncystic mass had a positive predictive value of 83%, and the presence of a cystic mass had a positive predictive value of 35%. The combination of a noncystic mass and fluid in the cul-de-sac (found in 22% of all patients with ectopic gestations) was the best predictor of an ectopic pregnancy with a 94% positive predictive value. It is suggested that the demonstration of a non-cystic mass, alone or in the presence of fluid in the cul-de-sac, be used as an indication for diagnostic laparoscopy.

Sonographic measurements of the fetal spleen: clinical implications.

Normal values for fetal spleen dimensions are proposed, including longitudinal, coronal, and transverse diameters, the perimeter, and the estimated volume. Similar values were then obtained in cases of Rh‐immunization and prolonged premature rupture of the membranes. A good correlation between amniotic fluid optical density and fetal spleen size was found. Only severely affected fetuses showed splenic values above the upper limit. Since sonographic examination can be regarded as a reliable method, nomograms can be useful in detecting growth disorders of the fetal spleen and thus provide a new complementary method to identify possible fetal diseases of genetic disorders.

The prenatal diagnosis of robin anomalad

The Robin anomalad was diagnosed by the sonographic detection of polyhydramnios and fetal micrognathia in a patient at risk because of a previously affected child. Ultrasound in the second trimester failed to demonstrate any facial anomaly, but mandibular hypoplasia was clearly documented in the third trimester. The antenatal diagnosis allowed immediate neonatal assistance to prevent glossoptosis-induced respiratory failure.

Vascular anatomy of the fetus.

Real‐time ultrasonography is utilized in this study to demonstrate most of the large vessels in fetuses from 22 weeks on. Images of the aorta, the coronary ostium, the vessels of the aortic arch, the carotids, the ductus arteriosus, the superior mesenteric artery, the celiac axis, the common iliac artery, the external iliac artery, and the femoral artery are demonstrated. Additionally, images of the subclavian vein, the superior mesenteric veins, the splenic vein, the portal vein, the hepatic veins, the ductus venosus, the renal veins, the iliac veins, and the inferior vena cava, as well as the pulmonary artery and veins and the azygos vein, are presented.

Facial anatomy of the fetus.

Real‐time ultrasonography was used in this study to demonstrate details of the anatomy of the face and neck of the fetus. Details such as the ocular globe, vitreous body, lens, anterior chamber, rectus muscles, optic nerve and disc, and the ophthalmic artery are visible at the level of the eye. The helix, scaphoid fossa, triangular fossa, concha, antihelix, antitragus, intertragic incisure, and lobule can be seen at the level of the ear. The tip of the nose, the alae nasi, and the columna are also seen. The epiglottis is visible in the vestibulum of the larynx. The fetal face is an important structure that can provide invaluable information in the search for congenital malformations, and possibly also in fetal behavior.