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Objective To present the normative data of the transverse diameter of the developing fetal thymus. Methods In this prospective study, the maximum transverse diameter of the thymus was measured by one sonologist in 376 normal fetuses between 19 and 38 weeks of gestation. We assessed the relationship of the transverse thymic diameter with gestational age (GA), biparietal diameter, femur length and abdominal circumference using general linear regression modeling. The predicted mean and 95% reference range of thymic diameter at each GA were calculated from the regression equation. Results Measurements of the transverse diameter were possible in 352 of the 376 (94%) fetuses. The transverse diameter of the fetal thymus increased with increasing GA and fetal size parameters in a linear manner. The regression equation for transverse diameter of the thymus as a function of GA was: thymic diameter (cm) = 0.15 x GA (weeks) — 1.59 (r2 = 0.86, P < 0.001). Conclusion The transverse diameter of the fetal thymus is easy to measure; this study presents normative data. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to evaluate the usefulness of measurement of the angle between bilateral renal pelves on axial views in the prenatal ultrasonographic diagnosis of horseshoe kidney. Methods We retrospectively measured the renal pelvic angle in 19 fetuses with horseshoe and 20 fetuses with normal kidneys in the second and third trimesters. Renal pelvic angle was defined as the angle between the long axis of the renal pelves on the axial view of the abdomen. We compared the renal pelvic angles of horseshoe and normal kidneys with unpaired t-test. Taking 140° as a cut-off value, we calculated the sensitivity, specificity and accuracy of pelvic angle measurement for the prenatal diagnosis of horseshoe kidney. Results The mean pelvic angles in the fetuses with horseshoe kidney were 116° and 110° in the second and third trimester, respectively. In the normal fetuses, the equivalent angles were 172° and 161°. The difference between the two groups was statistically significant (P < 0.01). Using 140° as the discriminating criterion, the sensitivity, specificity and accuracy of renal pelvic angle measurement for the prenatal diagnosis of horseshoe kidney were all 100%. Fifteen of 19 fetuses with horseshoe kidney had no other abnormality. Four (21%) fetuses had severe complex abnormalities which were associated with trisomy 18 in three cases. Conclusion Observation and measurement of the renal pelvic angle is a simple and useful method in the prenatal diagnosis of the horseshoe kidney. [ABSTRACT FROM AUTHOR]

Objectives To assess the prevalence, prenatal detection rate, and associated anomalies of congenital curly toe in an unselected obstetric population. Methods Between September 2001 and July 2002, 1167 singleton fetuses in the second and third trimesters underwent routine prenatal ultrasound at our hospital. Congenital curly toe was diagnosed when the fourth or fifth toe was not fully delineated on the axial image with medial and plantar flexion on the coronal image. All neonates underwent a physical examination within 3 days after delivery. Radiography was performed on those infants with curly toe. We assessed the prevalence, prenatal detection rate, and associated anomalies of the condition. Results There were 38 congenital curly toes among the 1167 neonates, yielding a total prevalence of 32.6 per 1000. In 26 of the 38 the fourth toe was curly and in 12 the fifth toe was curly. Of those in which the fourth toe was curly, 26.9% involved the right toe, 65.4% the left, and 7.7% involved both toes. For a curly fifth toe, these values were 25.0%, 16.7% and 58.3%, respectively. There was no associated structural anomaly, chromosomal abnormality, or syndrome in any case. Sixteen of the 38 curly toes were detected on prenatal ultrasound, including 13 of 26 with the fourth toe being curly and three of 12 with the fifth being curly. Conclusions Congenital curly toe is not an uncommon condition, and can be detected on the prenatal ultrasound. Although it usually appears as an isolated finding without clinical significance, thorough ultrasound examination of the fetus should be recommended. [ABSTRACT FROM AUTHOR]

AbstractObjectivesTo estimate the incidence of sonographic identification of pericardial fluid in normal fetuses and to evaluate the flow pattern of pericardial fluid by using color and spectral Doppler techniques. MethodsWe evaluated 27 normal fetuses for the presence of pericardial fluid by using gray-scale two-dimensional and M-mode ultrasound, and color and spectral Doppler techniques. ResultsPericardial fluid was detected in 52% of cases by two-dimensional and M-mode ultrasound and in 81% of cases by color Doppler. The pericardial fluid moved towards the ventricles during systole and towards the atria during diastole. In 9 of 22 fetuses with pericardial fluid identified by color Doppler, spectral waveforms were obtained. The waveforms confirmed the bidirectional flow pattern identified at color Doppler. In six cases there was monophasic systolic and biphasic diastolic flow. In the remaining three cases, the flow was monophasic during both systole and diastole. ConclusionsPericardial fluid can be identified with color Doppler in the majority of normal fetuses. It characteristically shows bidirectional flow as it moves with ventricular systole and diastole. Spectral waveforms can be obtained from the pericardial fluid. The presence of pericardial fluid per se should not be considered as abnormal. Color-coded pericardial fluid should not be mistaken for coronary artery blood flow. [ABSTRACT FROM AUTHOR]

A case of mixed intrahepatic arteriovenous shunts in a fetus diagnosed at 35 weeks' gestation is presented. Color Doppler ultrasonography in the fetal liver demonstrated complicated vascular connections fed by the hepatic arterial branches and drained into the portal and middle hepatic veins. Pulsed Doppler ultrasonography identified a high cardiac output state by the detection of increased flow velocities of the great vessels. The contribution of Doppler ultrasonography to hemodynamic changes is highlighted. The management is briefly discussed. [ABSTRACT FROM AUTHOR]

Fetal cardiac hemangioma is rarely diagnosed prenatally. We present here a fetus with such a tumor diagnosed at 28 weeks' gestation. With the use of fetal echocardiography, a mixed echogenic mass protruding outward from the right atrial wall was observed. Moderate amounts of pericardial effusion were also found. Although no apparent blood flow signal was detected in the mass, fetal echocardiography showed signs suggestive of a hemangioma. Differential diagnosis, management and prognosis are discussed. [ABSTRACT FROM AUTHOR]

An abstract of the conference paper "Outcome prediction of single-dose intramuscular methotrexate treatment for tubal pregnancy," by M.H. Moon and colleagues is presented.