Our study demonstrates that it is possible to visualize and measure the OC directly on a 2D ultrasound coronal plane. In fetuses with agenesis of the SP, the morphology and width of the OC visual pathway could prove a relevant tool for assessing its development. It would also help in the difficult task of providing antenatal counseling when faced with the diagnosis of agenesis of the SP. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Objective: To describe a technique for the visualization and measurement of cerebral aqueduct diameter through a 2D sagittal median plane, and to report its aspect and measurement in fetuses with aqueductal stenosis (AS). Methods: This was a cross-sectional study of 207 morphologically normal fetuses in low-risk pregnancies between 20 and 36 weeks of gestation. The cerebral aqueduct was visualized transvaginally in a midsagittal plane, and measurements of its greatest diameter (ampulla) were taken independently by an expert and a nonexpert sonographer. In addition, the aqueduct morphology from 7 fetuses with AS and complete follow-up were compared to the reference range. Results: Aqueductal measurements were obtained in 206 of 207 normal fetuses. Aqueductal growth occurred linearly with gestational age. Our method demonstrated excellent interobserver reproducibility. Among the 7 fetuses with AS, the aqueductal lumen could not be identified in 6 and had a funneling aspect in 1. Discussion: Our study demonstrated that it is possible to visualize and measure the cerebral aqueduct directly through a 2D ultrasound median plane. In fetuses with severe ventriculomegaly, the morphology and width of this structure could represent a relevant tool in improving AS diagnosis, differentiating it from other causes of significant ventricular dilation that carry a different outcome.

Congenital diaphragmatic hernia (CDH) is an unusual fetal malformation that requires early diagnosis and treatment. Commonly, presentations are in the left side (85%), followed by right (13%) and only very few (2%) bilateral. The last one is a severe condition associated with high mortality rates, and very rarely these cases survive for surgical treatment. We describe the case of a 34-week male fetus with pericardial effusion in transabdominal ultrasound. Pericardiocentesis was performed, and the presence of liver was noticed at the thoracic cavity, confirming a diaphragmatic hernia. The newborn presented acute respiratory distress and died 1 hour after birth. Necropsy revealed complete diaphragmatic agenesis, pulmonary hypoplasia, and incomplete intestinal malrotation. Survival of these patients depends on cardiopulmonary function. Bilateral agenesis of the diaphragm associated with incomplete intestinal malrotation is a rare entity, and its significance requires further research.

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