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Prenatal diagnosis of rubella infection was attempted at 21 to 23 weeks of gestation by measuring rubella-specific IgM by ELISA in blood obtained from 16 fetuses whose mothers had been confirmed rubella infection during pregnancy. Specific IgM was detected in 9 fetuses. In 1 case, the time of the appearance of the rash was 20 weeks of gestation and this pregnancy went to term resulting in a healthy baby without clinical evidence of congenital rubella. The remaining 8 patients had their pregnancies terminated, and fetal infection was confirmed by blood tests after the abortion. No specific IgM was detected in the 7 other fetuses. However, in 2 IgM fetal blood negative cases whose mothers had had the rash at 17 and 20 weeks of gestation, the neonates showed positive IgM findings, but were apparently healthy. The reasons for the false-negative findings are discussed.

A fetus with midgut volvulus is described. The mother had developed polyhydramnios, and the fetus was found by sonography to have dilated fluid-filled structures compressing the chest in the upper abdomen. Percutaneous aspiration of the upper abdominal mass was performed to identify the content and know whether decompressing the chest would be beneficial. The removal of meconium-stained fluid accomplished an improvement of the fetal biophysical profile. The infant was delivered by low transverse cesarean section, and survived with immediate removal of the fluid in the abdominal mass and ventilatory therapy.