Agnathia-otocephaly complex (AOC) is a rare and complex craniofacial malformation characterized by mandibular hypoplasia or agnathia, auricular fusion (synotia), and microstomia with oroglossal hypoplasia or aglossia. It can occur alone or in combination with forebrain anomalies and cardiac malformations and has an extremely poor prognosis. Here, we report a case of AOC diagnosed by systemic fetal screening at a gestational age of 25 +4 weeks. Ultrasound revealed that the S-curve formed by the normal lower jaw and lower lip had disappeared, the lower jaw and mandible were invisible, the mouth was extremely small, and the oral fissure was "pinhole-shaped". There was a cone-shaped perioral bulge.Both ears were located in the front side of the neck, and the right foot was inverted. Excessive amniotic fluid was observed. The absence of a mandible was confirmed on X-ray examination after induced abortion.Specimen observation showed that the ear positions were extremely low, and both earlobes were connected in the front side of the neck. It was particularly challenging to identify the development of the mandible and locate auricles during prenatal ultrasound diagnosis, and the prenatal diagnosis of AOC was confirmed by combining two-dimensional and three-dimensional ultrasound in our current case.

Retroesophageal or retrotracheal left brachiocephalic vein (LBCV) is a rare anatomic variant that is often associated with congenital heart disease. It is rarely reported in fetal life, and an isolated fetal retroesophageal LBCV has a good prognosis: it is typically asymptomatic, although respiratory symptoms or swallowing disorders occasionally occur. A variant was observed on fetal echocardiography at 22 +6 weeks of gestation. The 3-vessel view revealed a transverse section of a vessel to the left of the pulmonary artery.Tracing upwards along its long axis showed that the left subclavian vein joined the left internal jugular vein to form the LBCV, and tracing downwards revealed that the vessel traveled to the right and lower side, where it merged into the superior vena cava via the azygos vein behind the aortic arch. The variant was identified as retrotracheal LBCV. Three-dimensional (3D) reconstruction of fetal great vessels was performed using temporal spatial correlation imaging. The left internal jugular vein and the left subclavian vein converged into the LBCV, then bypassed behind the trachea and converged into the superior vena cava via the azygous vein. As a 3D technique, spatio-temporal image correlation (STIC) can visualize the abnormal courses of LBCV, thus improving the diagnostic accuracy. This article presents the 2-dimensional (2D) ultrasound, color Doppler, and STIC findings of an isolated retrotracheal LBCV, which may inform the sonographic diagnosis of such variants.

Background: Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovarian stimulation in assisted reproduction technology (ART). The aim of this study was to evaluate if the combined treatment with prednisone and bromocriptine will reduce the risks of ovarian hyperstimulation syndrome (OHSS) and influence the pregnancy outcomes in fresh embryo transfer cycles. Method: Retrospective study was performed and Infertile patients undergoing assisted reproduction techniques were recruited. Results: The cancellation rate for OHSS in the combined group was 31.45%, while the control group was 40.88%. There was a significant reduction of the OHSS cancellation rate between the combined group and the control group (P<0.001). The single embryo transfer had been completed in 350 cycles in the combined group, and 495 cycles for double embryos transfer. Single embryo transfer were just only 227 cycles for the control group, while 517 cycles for double embryos transfer (P<0.001). As for the total successful embryo implantation, 509 cycles were in the combined-treated group (40.88%), while the 442 cycles in the control group which have the statistical differences between them (38.30%, P= 0.012). There was no statistical difference in clinical pregnancy rate (P=0.492), miscarriage rate(P=0.792), ongoing pregnancy rate(P=0.719), live birth rate(P=0.295), the congenital abnormalities rate (P=0.081), and the ectopic pregnancy occurrence rate(P=0.649) between the combined group and the control group. Conclusion Compared with the bromocriptine single using, combined-treated bromocriptine with prednisone can better reduce the OHSS occurrence rate dramatically and effectively and not affect the pregnancy outcomes in fresh embryo transfer cycles.

Background: Ovarian hyperstimulation syndrome (OHSS) is a severe complication for infertile patients undergoing assisted reproduction technology (ART) treatment. Bromocriptine and prednisone are often used for treating OHSS. This study aimed to evaluate whether combined treatment with prednisone and bromocriptine can reduce the risk of OHSS and influence pregnancy outcomes in fresh embryo transfer cycles.Methods: This retrospective study recruited infertile patients undergoing assisted reproduction techniques. We included 4,114 cycles of infertile patients who underwent IVF or ICSI treatment between January 2014 and May 2017 and divided them into two groups: the combined-treatment group and the single-treatment group.Results: The OHSS cancellation rates in the combined- and single-treatment (control) groups were 31.50% and 40.88%, respectively. There was a significant reduction in the OHSS cancellation rate between the combined- and single-treatment groups (P<0.001). Single- and double-embryo transfers were completed in 350 and 495 cycles, respectively, in the combined-treatment group and in 227 and 517 cycles, respectively, in the single-treatment group (P<0.001). The total number of successful embryo implantation was significantly different between the combined-treatment group (509 cycles, 40.88%) and single-treatment groups (442 cycles, 38.30%) (P=0.012). There was no statistically significant difference in the clinical pregnancy (P=0.492), miscarriage (P=0.792), ongoing pregnancy (P=0.719), live birth (P=0.295), congenital abnormality (P=0.081), and ectopic pregnancy occurrence rates (P=0.649) between the combined- and single-treatment groups.Conclusion: Compared with bromocriptine alone, combined treatment with bromocriptine and prednisone can better reduce the OHSS occurrence rate and does not affect the pregnancy outcomes in fresh embryo transfer cycles.