high association between trisomy 21 and absence of the nasal bone at firsttrimester sonography (11-14 weeks' gestation) has been established. [1][2][3] The presence or absence of the nasal bone was found to be independent of other maternal or fetal variables and thus may be added to other sonographic markers for prenatal detection of trisomy 21. 3 Bromley et al, 4 later Bunduki et al, 5 and others 6 confirmed a mid-second-trimester (15-22 weeks' gestation) association of an absent or hypoplastic nasal bone and trisomy 21. In addition, an absent nasal bone at the 11-to 14-week sonographic scan has been associated with other fetal aneuploidies. 7,8 Cicero et al 7 reported an absent nasal bone in 161 (66.9%) of 242 fetuses with trisomy 21, 48 (57.1%) of 84 fetuses with trisomy 18, 7 (31.8%) of 22 fetuses with trisomy 13, 3 (8.8%) of 34 fetuses with 45,XO, and 4 (8.3%) of 48 fetuses with other aneuploidy defects (XXX, XXY, XYY, and triploidy). The association of an absent or hypoplastic nasal bone and aneuploidies other than trisomy 21 was confirmed by Odibo et al 8 We report a case in which sonographic depiction of an absent nasal bone at 20 weeks' gestation led to amniocentesis and the detection of a fetus with cri du chat (5p-) syndrome.

cervical pregnancy is an uncommon ectopic pregnancy that accounts for less than 1% of such gestations. 1 This condition is associated with an extremely high risk of massive hemorrhage and previously often required hysterectomy. 1 The current diagnostic modality of this potentially lifethreatening condition is transvaginal sonography, supported at times by magnetic resonance imaging. [2][3][4] The definitive diagnostic imaging feature of a cervical pregnancy is the location of a gestational sac in the cervix in the presence of a closed internal uterine cervical os. [2][3][4][5][6][7] We report the 3-dimensional transvaginal sonographic findings of a cervical pregnancy at 6 weeks' gestation.Received August 8, 2007, Case ReportA 34-year-old woman, gravida 3, para 0, came to the emergency department at State University of New York Downstate Medical Center with mild uterine hemorrhage. Her medical history was unremarkable. The patient had 2 previous spontaneous first-trimester miscarriages. Physical examination revealed a healthy individual. She was afebrile with a blood pressure of 120/78 mm Hg, a pulse of 84 beats per minute, and a respiratory rate of 20 breaths per minute. Her abdomen was soft and nontender, with no peritoneal signs elicited. Bimanual pelvic examination disclosed a soft, mildly enlarged uterus. Both adnexa were normal. The cervix was long and closed and appeared boggy on inspection.Laboratory test results revealed a hemoglobin level of 13.6 g/dL, a hematocrit value of 42%, a white blood cell count of 7.29 × 10 9 /L, and a platelet count of 255 × 10 9 /L.

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