CONTRIBUTION What are the novel findings of this work?In fetuses with open spinal dysraphism, the presence of a myelomeningocele sac and larger sac size are associated with fetal talipes. What are the clinical implications of this work?The findings of this study suggest that the risk of talipes is increased in fetuses with open spinal dysraphism with a myelomeningocele sac, and that the risk is correlated with sac size. These results also have implications for in-utero treatment of myelomeningocele as they suggest that the fetal spinal cord and nerves are uniquely sensitive to stretch injury. ABSTRACT Objective To determine whether the presence of a myelomeningocele (MMC) sac and sac size correlate with compromised lower-extremity function in fetuses with open spinal dysraphism.Methods A radiology database search was performed to identify cases of MMC and myeloschisis (MS) diagnosed prenatally in a single center from 2013 to 2017. All cases were evaluated between 18 and 25 weeks. Ultrasound reports were reviewed for talipes and impaired lower-extremity motion. In MMC cases, sac volume was calculated from ultrasound measurements. Magnetic resonance imaging reports were reviewed for hindbrain herniation. The association of presence of a MMC sac Correspondence to: Dr E. R. Oliver,

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Congenital lobar overinflation should be considered in cases of prenatal echogenic lung lesions without macrocysts or classic findings of bronchial atresia. Hypervascularity may be an important imaging feature of a subset of CLO. Most cases become less conspicuous, decrease in size without overt hydrops, and are asymptomatic postnatally.

Lymphatic malformations are benign lesions that result from abnormal development of the lymphatic and venous systems. These lesions may be detected during routine prenatal ultrasound screening, and typically demonstrate imaging findings of a multiseptate cystic lesion lacking solid components, vascularity, and calcifications. We report 73 cases of prenatally detected lymphatic malformations and describe greater variability in their prenatal sonographic appearance than previously reported, including purely cystic lesions and mixed cystic and solid lesions with calcifications. Appreciation of this increased variability is important in providing accurate prenatal diagnosis, counseling, and management.

What are the novel findings of this work?This study presents the prenatal ultrasound findings and postnatal outcome of patients with left congenital diaphragmatic hernia (CDH) without liver herniation according to stomach position, demonstrating, for the first time, decreased morbidity in those without ('stomach-down' CDH) compared to those with ('stomach-up' CDH) intrathoracic stomach herniation. This is the first study to suggest stomach-down CDH as a separate entity. What are the clinical implications of this work?Our findings highlight the importance of identifying stomach-down CDH prenatally and distinguishing this entity from a congenital lung lesion and from stomach-up CDH, as contralateral lung size is insufficient for predicting postnatal outcome. This knowledge can better inform prenatal family counseling and help anticipate postnatal management.