Objective To evaluate the prefrontal space ratio (PFSR) in second-and third-trimester
ResultsIn the euploid and trisomy 21 groups, the median gestational age at the time of ultrasound examination was 21.1 (range, 15.0-40.0) and 21.4 (range, 15.0-40.3
Objective: To investigate the proportion and type of fetal anomalies that are associated with polyhydramnios and to examine whether in cases with idiopathic polyhydramnios during the course of pregnancy and fetal anomalies only diagnosed after birth, antenatal characteristics differ. Methods: This was a retrospective study involving all pregnancies with polyhydramnios defined by a deepest pool of amniotic fluid ≥8 cm and a detailed ultrasound examination, a 75 g glucose tolerance test and a TORCH serology. Results: Between 2004 and 2010, 272 pregnancies fulfilled the inclusion criteria. In 89 (32.7%) and 65 (23.9%) cases, there was a fetal anomaly or diabetes. In 118 (43.4%) pregnancies, polyhydramnios was classified as idiopathic. In 11 (9.3%) of the 118 fetuses, an anomaly was found after birth, mainly gastrointestinal atresia. In these cases, median deepest pool of amniotic fluid was 9.6 cm, and median estimated fetal weight was at the 69th centile, whereas in cases without anomalies diagnosed after birth, median deepest pool was 9.0 cm and median estimated fetal weight at the 90th centile (Mann-Whitney U test: deepest pool p = 0.116, and estimated fetal weight centile p = 0.377). There was also no difference in the maternal and gestational age distribution of these cases (Mann-Whitney U test: maternal age p = 0.293, and gestational age p = 0.499). Conclusion: In about 40% of pregnancies, polyhydramnios remains unexplained during the course of pregnancy. In 10% of these cases, an anomaly will only be found after birth. In this group, antenatal characteristics such as amniotic fluid volume, estimated fetal weight or gestational and maternal age at the time of diagnosis do not help to detect these anomalies before birth.
Using stored images, each of the measurement techniques is highly reproducible. Both the two-line and the tracing methods yield larger measurements than the single-line technique. Therefore, it appears that in select cases the straight line measurement significantly underestimates the actual cervical length.
Introduction: Our purpose was to examine whether the prenatal prediction of a critical birth weight discordance (BWD) in twin pregnancies can be improved by using either different formulae for prenatal fetal weight estimation or single biometric measurements or by assessing the intertwin discordance in the second trimester rather than shortly before birth. Material and Methods: We conducted a retrospective study involving 196 twin pregnancies with an ultrasound examination between 18 and 25 weeks of gestation and one within 14 days prior to delivery. The accuracy was assessed by comparing the prenatal intertwin discordance (PID) with the BWD. PID was estimated by 5 common fetal weight estimation formulae and by single biometric measurements prior to delivery and in the second trimester. Results: The fetal weight estimation accuracy was similar in mono- and dichorionic pregnancies and the smaller and the larger twin. PID was most accurate with the fetal weight estimation formulae prior to delivery. The second-trimester measurements resulted in an underestimation of the BWD. Detection and false-positive rates for a BWD ≧20% were about 65 and 15%. Discussion: About two thirds of the twin pregnancies with a relevant BWD can be detected prior to delivery. An optimal detection rate requires fetal weight estimation close to delivery.
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