Pil-Ryang Lee

Spontaneous resolution of prenatally diagnosed dural sinus thrombosis : a case report

Fetal thrombosis of the dural sinus is an extremely rare congenital cerebrovascular condition that is potentially fatal. We report a case of dural sinus thrombosis diagnosed by prenatal ultrasonography and fetal magnetic resonance imaging (MRI) in the second trimester. The thrombosis showed partial resolution during pregnancy and resolved spontaneously after birth without neurological complications. This is the first report of spontaneous postnatal resolution, and may provide helpful information on the natural history and prenatal counseling of fetal thrombosis of the dural sinus. Copyright

Perinatal outcome of sacrococcygeal teratoma

To evaluate the outcome in a cohort of fetuses with isolated sacrococcygeal teratoma (SCT) in relation to the need for in utero intervention.

Four-dimensional ultrasound guidance of prenatal invasive procedures

Technological advances in ultrasonography have revolutionized prenatal diagnosis and treatment. Here we evaluate the effectiveness of using four‐dimensional (4D) ultrasonography to guide prenatal invasive procedures.

One case of increased intracranial translucency during the first trimester associated with the Dandy–Walker variant

A 33-year-old multigravida was referred to our fetaltreatment center for early oligohydramnios at 11+2weeksof gestation. The examinations were performed using anAccuvix XG (Samsung Medison Co., Ltd, Seoul, Korea) with a2 to 6MHz transabdominal probe. The fetal size was compatiblewith the gestational age (crown –rump length (CRL): 45.4mm).Ultrasound showed IT enlargement of 3mm. We could notmeasure the nuchal translucency (NT) because of the smallamniotic sac. Follow-up ultrasound at 13+0weeks of gestationrevealed that the CRL was 71.7mm, the IT was still enlarged(3.7mm), and micrognathia was suspected (Figure 1). Theamniotic sac was becoming larger, and the NT was normal(1.1mm). Two weeks later, we performed amniocentesis forkaryotyping,andwhichyieldedanormalresult(46,XY).Thepatient was lost to follow-up until 23+2weeks of gestation.Ultrasonography showed hypoplasia of the cerebellar inferiorvermis without marked enlargement of the posterior fossa(Figure 2). No other abnormality of the central nervous systemwas observed. Retrognathia rather than micrognathia wassuspected. We counseled the parents regarding the prognosisand they decided to continue the pregnancy. Follow-upultrasound at 31+2weeks of gestation demonstrated the samefindings. The male infant was delivered vaginally at 39+0weeksof gestation, and bilateral cleft palates with retrognathia werenoted. Postnatal brain magnetic resonance imaging showedmild hypoplasia of the inferior cerebellar vermis with normalposterior fossa. The baby was doing well when seen for theone-month follow-up.

Diagnostic value of the matrix metalloproteinase-8 rapid test for detecting microbial invasion of the amniotic cavity

The purpose of this paper was to compare the MMP-8 PTD Check (MPC) test with other indirect tests for detecting microbial invasion of the amniotic cavity (MIAC). Amniotic fluid (AF) was analyzed in 155 women for white blood cell (WBC) count, glucose concentration, and an MPC test and evaluated for MIAC using cultures for aerobic/anaerobic bacteria and mycoplasmas and polymerase chain reaction (PCR) of chlamydia. The median AF glucose concentration was lower and the median AF WBC count was higher in women with MIAC than in women without MIAC (p < 0.01 and p < 0.001, respectively). Also, the positive rate of the MPC test was higher in women with MIAC than in women without MIAC (p < 0.001). The sensitivities of AF glucose concentration, AF WBC count, and the MPC test for the detection of MIAC were 58.6%, 75.9%, and 86.2%, respectively. The specificities for the detection of MIAC were 76.2%, 80.2%, and 74.6%, respectively. We conclude that the MPC test is a rapid, easily performed, and accurate indirect method for detecting MIAC.

Progesterone modulates the expression of interleukin-6 in cultured term human uterine cervical fibroblasts.

Citation Kim M‐G, Shim J‐Y, Pak JH, Jung B‐K, Won H‐S, Lee P‐R, Kim A. Progesterone modulates the expression of interleukin‐6 in cultured term human uterine cervical fibroblasts. Am J Reprod Immunol 2012; 67: 369–375

Perinatal outcomes of fetal pleural effusion following thoracoamniotic shunting

The aim is to evaluate perinatal outcomes of fetal pleural effusion after thoracoamniotic shunting.

Intrauterine therapy for macrocystic congenital cystic adenomatoid malformation of the lung

Objective To report on our experiences with thoracoamniotic shunting and/or the injection of a sclerosing agent (OK-432) to treat fetuses diagnosed with macrocystic congenital cystic adenomatoid malformation (CCAM) of the lung. Methods A retrospective study was undertaken in six fetuses with macrocystic CCAM at our institute that had been confirmed by postnatal surgery between August 1999 and January 2012. Results Six fetuses that had been diagnosed with macrocystic CCAM were analyzed. The median gestational age at diagnosis was 23.5 weeks (range, 19.5-31.0 weeks), and at the time of primary treatment was 24.0 weeks (range, 20.5-31.0 weeks). The mean size of the largest cyst at the initial assessment was 42.5±15 mm. Four fetuses were associated with mediastinal shifting, and one also showed fetal hydrops. All fetuses underwent a shunting procedure within the cysts, one case among them was also treated with OK-432. After the completion of all procedures, the mean size of the largest cyst was all decreased (14.2±12 mm). The median gestational age at delivery was 38.0 weeks (range, 32.4-40.3 weeks). All of the newborns underwent the surgical resection at a median age of 6 days (range, 1-136 days) and are currently doing well without any complications. Conclusion We suggest that intrauterine decompression therapy to manage fetal macrocystic CCAM is recommendable treatment for good perinatal outcome.

Molecular genetic, cardiac and neurodevelopmental findings in cases of prenatally diagnosed rhabdomyoma associated with tuberous sclerosis complex

Rhabdomyoma is the most common type of cardiac tumor in fetuses and is often associated with tuberous sclerosis complex (TSC) with neurologic sequelae. The purpose of this study was to investigate the cardiac and neurodevelopmental outcomes of fetal rhabdomyoma.

Measurement of intracranial translucency using three-dimensional ultrasound and Volume IT™

To establish the reference range of intracranial translucency (IT) in the Korean population, and to evaluate whether Volume IT™ is a reliable technique for measuring IT.