Additional imaging through the posterolateral fontanelle during routine neonatal cranial sonography added considerable benefit. False-positive diagnosis of vermian defects is a troubling problem but may be avoided with careful attention to the midline sagittal sonographic images of the vermis and fourth ventricle.

The frontal lobe is statistically significantly smaller in fetuses with trisomy 21. US measurement of the FTD may prove to be a useful adjunctive screening tool if used with other markers for Down syndrome.

Ultrasonographic contrast agents that stay within the vascular space and do not cross the placenta may permit differentiation between the maternal and fetal portions of the placenta and may be clinically useful for diagnosis of placental abnormalities. This study was performed to assess the effects of Levovist (Schering AG, Berlin) on the placental circulation and to determine whether hemodynamic effects on the fetus occur. Ten studies were performed in five pregnant macaques (median weight, 9.15 kg; range, 6.15 to 11 kg; median gestational age, 121 days; range, 34 days to term) under anesthesia. Gray scale, color, and duplex Doppler sonographic scans of the fetus and placenta were acquired using a 5 MHz curved array transducer. Fetal heart rate, resistive index, and systolic‐diastolic ratios were measured in the fetal middle cerebral artery, aorta, umbilical artery, and uterine artery before and after administration of contrast agent. The following dose regimen was tested: 5 ml of physiologic saline solution followed by 0.1 ml/kg of 300 mg/ml Levovist (diagnostic dose), 0.5 ml/kg of 400 mg/ml Levovist (maximum dose), and 5 ml physiologic saline solution. The order of diagnostic dose and maximal dose was randomized among animals. Color enhancement of the basal portions of the placenta was documented after administration of contrast agent. Heart rate and middle cerebral artery systolic‐diastolic ratio did not change between baseline and injections. A 7% decrease of the resistive index from baseline to maximum dose was measured in the uterine artery (not significant). A 7.7% decrease in the systolic‐diastolic ratio from baseline to maximum dose was recorded in the umbilical artery. However, an identical change was measured after saline solution was injected. The resistive index in the aorta increased by 2.6% from baseline to maximum dose, a change that was not significant (P > 0.5). Ultrasonographic contrast enhancement of the maternal circulation in placenta is demonstrated to be without significant effects on the fetal circulation as measured in this limited population.

The placenta is an important part of every obstetric ultrasound examination, but its evaluation is often underemphasized. Important abnormalities of the placenta can be detected by ultrasound2014some of them before they adversely affect the fetus. Most of these abnormalities are vascular and include subchorionic hemorrhage, intervillous thrombosis, and placental abruption. The authors present a placental vascular anomaly not described previously. A transiently filling and emptying retroplacental and subchorionic space, corresponding with venous flow, is described by the authors. Throughout an 18-month period, three cases were observed. The pregnancy outcomes were good in all cases, with healthy neonates at birth. The clinical course and pregnancy outcome of these three cases are described.