Although not significant, BRCA mutation carriers tended to have more advanced disease at diagnosis. However, the survival was similar irrespective of the BRCA status in this small group. Further research is needed to confirm these findings in a larger cohort.
Objectives
To construct a nomogram of fetal stomach, and to prospectively determine the clinical value of stomach measurement in pathological cases.
Methods
A cross‐sectional prospective study was conducted between 14 and 40 weeks in well‐dated, low‐risk, singleton pregnancies. Stomach dimensions were acquired in longitudinal plane in which maximal stomach length was measured, and in axial plane in which were measured: antero‐posterior and latero‐lateral. Stomach maximal and axial 1st to 99th centiles were calculated for each gestational‐week.
Results
Five hundred fifty‐four measurements were performed. A cubic polynomial regression model best described the correlation between stomach size and gestational age. The correlation coefficient (r2) was 0.627 and 0.754 (p < 0.001) for the stomach axial and maximal diameters, respectively. Intra‐ and interobserver variability had high interclass correlation coefficients (>0.9). Nomograms were created for predicted stomach axial and maximal 1st, 3rd, 10th, 25th, 50th,75th, 90th, 95th, 97th, and 99th centiles. The nomogram correctly detected 92.3% (12/13) of pathological cases including three bowel obstruction, eight esophageal atresia, and two hypotonic syndromes.
Conclusions
The present study provides updated nomograms of the fetal stomach. Clinical application of these nomograms may assist in preventing unnecessary investigation in falsely perceived small or large stomachs and may improve the in utero detection of true pathologies.
Literature supporting the use of point‐of‐care ultrasound (POCUS) for both identification and aspiration of effusions in large joints in the pediatric emergency department (PED) is sparse. We collected a case series of five patients who presented to the PED from August 2020 to December 2020 with an effusion in the hip, shoulder, knee, or elbow identified and aspirated under POCUS performed by pediatric emergency medicine (PEM) physicians. POCUS confirms effusion location and size and visualization of a completely evacuated effusion. POCUS can also guide the decision to start antibiotics earlier in the course of illness, can prevent unnecessary transfers for formal sonographic imaging or for potentially unnecessary radiographic imaging. This series supports the role of a PEM physician and POCUS guidance in the identification and aspiration of large‐joint effusions.
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