Modern ultrasound imaging devices have increasingly allowed sophisticated prenatal diagnoses of fetal disorders. Embryopathologic and ultrasound findings are reported in five cases of alobar holoprosencephaly that were diagnosed prenatally, two cases as early as 23 menstrual weeks. Specific sonographic findings included a large central cranial fluid collection (a monoventricular cavity lacking ventricular horns and midline structures), a fused thalamus at the floor of this cavity, and characteristic facial features (proboscis, single orbit, single nostril, or severe hypotelorism). Differential diagnosis of the fetus with a large intracranial fluid collection is discussed and illustrated.

In this retrospective study of 19 patients with hemorrhagic cholecystitis, 14 (74%) patients demonstrated one of the following unusual sonographic features: focal gallbladder wall irregularity; intraluminal membranes; coarse, nonshadowing, nonmobile intraluminal echoes. The clinical presentation of these cases (abdominal pain, 100%; leukocytosis, 74%; fever, 63%) is identical to the classic presentation of acute cholecystitis. Overt gastrointestinal bleeding did not occur.

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Reported survival rates in nonimmune hydrops fetalis vary considerably. Among 27 fetuses exhibiting severe sonographic features of nonimmune hydrops fetalis, 33% survived the neonatal period. For five of the nine survivors, the prognosis remains uncertain or poor. On the basis of sonographic features alone neither prognosis nor potential survivors were reliably predicted.

Seven infants born at our institution between July 1979 and June 1982 had congenital diaphragmatic hernia (CDH). Four cases of CDH were correctly identified by fetal ultrasonography. Diagnosis relied upon the demonstration of abdominal organs within the thorax. During this period, no false positive diagnoses of CDH were made. Significant associated sonographic features included polyhydramnios, mediastinal displacement, and distorted upper abdominal anatomy.