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obtain the values of EV: XI VOCAL method. Using a sequential section, the contour of each gestational embryo was drawn manually in the fifteen different rotation planes to obtain the 3D volume measurement. To evaluate the relation between EV and gestational age (GA), Person’s correlation coefficient (r) was used. The paired Student’s t-test (P) and ANOVA were used to compare the methods. Results: The study showed there was correlation between EV and GA (r = 0.83 for VOCAL 30 degrees, r = 0.83 for XI VOCAL and r = 0.80 for multiplanar). There was a strong correlation between EV measured by the XI VOCAL e multiplanar methods (RICC = 0,941) and XI VOCAL and VOCAL methods (RICC= 0,965). There weren’t difference statistics between EV measured by the VOCAL, XI VOCAL and the multiplanar by the paired Student’s t-test, but ANOVA showed differences between all methods (p < 0.001). Conclusion: We have demonstrated a strong correlation with the age gestational and embryo volume measurements obtained using the XI VOCAL, VOCAL and multiplanar methods in first trimester gestational. The methods were concordant, but there were differences statistics.

Objectives: Our aim is to describe the technique of fetal intracranial pressure (FIP) assessment developed by using a safe and accurate system of invasive pressure monitoring and registering. Methods: By performing a fetal ultrasound-guided cephalocentesis in the fetal parieto-occipital fissure we may reach the posterior horn of the ventricular cavity. The procedure requires local anesthesia, little or no maternal sedation and no fetal curarization. The technique relies on the use of a sterile disposable pressure transducer that relays pressure information from the intraventricular catheter to a digital monitor in real time. It requires less than 5 seconds for the system to read and plot the pressure values into a graphic describing a straight line with low amplitude oscillations. The pressure transducer has a test port that allows one to verify the accuracy of the system before the fetal punction, minimizing the procedure time. The sensitivity is 5.0 μ V/V/mmHg ±1%, adequate to low pressure ranges. Fetal heart beats should be monitored for bradycardia may occur. Patient should be given uterolythics and has low risk of preterm rupture of membranes after procedure. Discussion: Congenital hydrocephaly has a wide spectrum of presentations and is related to multiple factors. Prognosis depends on the underlying cause, presence of associated malformations, the gestacional age of onset and progression of the ventricle enlargement with brain injury by intracranial hypertension. The FIP assessment may select those who could benefit from intrauterine ventricular derivations, in advanced and progressive cases. The FIP is estimated to be 2mmHg or less in normal fetuses and should be much higher in obstructive hydrocephaly, leading to parenchymal compression and neuronal migration impairment. Conclusions: The technique of FIP measurement is described. Fast, accurate and low-risk assessment may add important information and greatly improve outcome of fetuses with hydrocephaly.

Primary renal agenesis is not a diagnostical challenge as oligohydramnios is almost always present at the time of the anomaly scan. In contrast secondary (or progressive) renal agenesis (e.g. in multicystic dysplastic kidney) is frequently missed as kidneys are present but smaller in size and they tend to vanish with advancing gestational age. We present a case of a 24-year-old woman, gravida 1 para 0, referred to our center at 24+3 weeks’ gestation for suspicion of IUGR and oligohydramnios. Ultrasound showed a small multicystic left kidney. The right kidney could not be visualized. In view of the challenging scan conditions and the fact that normal kidneys were documented on previous exams a fetal MRI was requested. This case stresses the possibility of MCDK and other forms of cystic renal dysplasia in fetuses with oligohydramnios – even if a normal urinary tract was visualized on earlier exams. From our experience MRI as an alternative to amnioninfusion was decisive in confirming the diagnosis.