Shengli Li

Prenatal diagnosis of congenital vascular rings and slings: sonographic features and perinatal outcome in 81 consecutive cases.

To describe the sonographic features and perinatal outcome of congenital vascular rings diagnosed prenatally at a single tertiary care institution.

Spontaneous Rupture of the Spleen: A Rare but Serious Case of Acute Abdominal Pain in Pregnancy

BACKGROUND Spontaneous (non-traumatic) rupture of the spleen rarely occurs in the setting of a normal spleen, especially during pregnancy. OBJECTIVES We report a case of spontaneous rupture of a normal spleen at 33.7 weeks gestation and review the literature with the aim of exploring the etiology, diagnosis, and management of this condition during pregnancy. CASE REPORT A 30-year-old Chinese primigravida presented at 33.7 weeks gestation with acute onset of severe, constant left upper abdominal pain. She developed acute hypotension. Physical examination revealed diffuse abdominal tenderness with rebounding and guarding. An emergent cesarean delivery and abdominal exploration was performed. A non-viable male infant was delivered, and active bleeding was identified at the splenic hilum consistent with splenic rupture. A splenectomy was performed, and a consumptive coagulopathy was identified and treated. The patient had an uncomplicated postoperative course and was discharged home on postoperative day 15. CONCLUSION Splenic rupture in pregnancy is a life-threatening complication. Early diagnosis and aggressive surgical intervention will allow for optimal maternal and perinatal outcome.

The role of doppler waveforms in the fetal main pulmonary artery in the prediction of neonatal respiratory distress syndrome.

To describe changes in the Doppler waveforms of the fetal main pulmonary artery (MPA) throughout gestation and to assess their predictive value of neonatal respiratory distress syndrome (RDS).

Prenatal diagnosis and perinatal outcome of congenital dacryocystocele: a large case series.

To describe the incidence, prenatal diagnosis, and perinatal outcome in fetuses with congenital dacryocystocele.

Correlation between Congenital Heart Defects and maternal copper and zinc concentrations

BACKGROUND The aim of this study was to investigate the correlation between maternal concentrations of copper and zinc and the risk of having an infant with a congenital heart defect (CHD). METHODS A multi-center hospital-based case-control study was conducted in China. A total of 212 cases and 212 controls were recruited from pregnant women who received prenatal examinations in four tertiary hospitals accredited to perform prenatal diagnosis in the cities of Shenzhen, Zhenzhou, Fuzhou and Wuhan between February 2010 and November 2011. Correlation between CHDs and maternal copper and zinc concentrations was estimated by a 1:1 conditional logistic regression. Also the interaction between copper and zinc was analyzed. RESULTS Compared with the controls, mothers with hair copper concentrations of 17.77 μg/g or more were more likely to have a child with a CHD than those with a lower concentration. The adjusted odds ratio was 5.70 (95% confidence interval, 2.58-12.61) for CHDs and 6.32 (95% confidence interval, 2.11-18.92) for conotruncal defects. Zinc concentrations were not significantly different in the case and control groups. The results suggest that mothers whose zinc content was 104.60 μg/g or less did not have a significantly higher risk of having a child with a CHD. No interaction between maternal copper and zinc concentrations was observed in the multiplicative or additive model. CONCLUSION Women with excessive copper concentrations have a significantly increased risk of having offspring with a CHD. A low maternal zinc status might have a correlation with CHDs, and an interaction between copper and zinc might exists, but an epidemiological study with a larger sample size is needed to confirm this finding.

Prenatal diagnosis of criss-cross heart: sonographical and pathological features of five cases

Objective:To describe the sonographical and pathological features of fetal criss-cross heart (CCH).Study Design:All cases of fetal CCH diagnosed by fetal echocardiogram from May 2003–May 2011 were identified at a single referral center using an established perinatal database. Demographic and genetic information, sonographical images and autopsy reports were reviewed. Sonographical and pathological features are described.Result:Five cases of fetal CCH were identified, all of which were confirmed by autopsy. Characteristic sonographical findings include: (1) the inability to obtain four-chamber view at standard transverse plane through the fetal chest; (2) appreciation of the misaligned spatial atrial–ventricle connection with the interventricular septum in a ‘spiraling’ orientation; (3) orientation of the two ventricular inlets in a superior–inferior and crossing position; and (4) a four-chamber-like view seen in the sagittal plane of the fetal chest. Doppler ultrasound demonstrates the ‘criss-cross’ arrangement of the inflow tracts into the two ventricles simultaneously in the transverse plane of the fetal chest.Conclusion:CCH is a rare developmental disorder that can be accurately diagnosed prenatally. Early diagnosis will allow for more targeted counseling and early intervention.

Routine screening for fetal limb abnormalities in the first trimester

We aim to determine the accuracy of first‐trimester ultrasonography in detecting fetal limb abnormalities.

First-Trimester Echocardiographic Features and Perinatal Outcomes in Fetuses With Congenital Absence of the Aortic Valve

The purpose of this study was to describe the echocardiographic features and perinatal outcomes of congenital absence of the aortic valve diagnosed by first‐trimester echocardiography.

Ultrasonographic Characteristics of Cortical Sulcus Development in the Human Fetus between 18 and 41 Weeks of Gestation

Background: Fetal brain development is a complicated process that continues throughout pregnancy. Fetal sulcus development has typical morphological features. Assessment of fetal sulcus development to understand the cortical maturation and development by prenatal ultrasound has become widespread. This study aimed to explore a reliable method to assess cortical sulcus and to describe the normal sonographic features of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation. Methods: A cross-sectional study was designed to examine the fetal cortical sulcus development at 18–41 weeks of gestation. Ultrasound was used to examine the insula, sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine fissure (CF). Bland-Altman plots were used for assessing the concordance, and the intraclass correlation coefficient was used for assessing the reliability. Results: SF images were successfully obtained in 100% of participants at 22 weeks of gestation, while the POF images and CF images could be obtained in 100% at 23 weeks of gestation and 24 weeks of gestation, respectively. The SF width, temporal lobe depth, POF depth, and the CF depth increased with the developed gestation. The width of uncovered insula and the POF angle decreased with the developed gestation. By 23 weeks of gestation, the insula was beginning to be covered. Moreover, it completed at 35 weeks of gestation. The intra- and inter-observer agreements showed consistent reproducibility. Conclusions: This study defined standard views of the fetal sulcus as well as the normal reference ranges of these sulcus measurements between 18 and 41 weeks of gestation. Such ultrasonographic measurements could be used to identify fetuses at risk of fetal neurological structural disorders.