Transvaginal ultrasonographic detection of congenital anomalies in the first trimester

Article Abstract:

Ultrasonography is a method in which sound waves are used to visualize internal body structures. Transvaginal ultrasonography is a modification of ultrasonography in which the transducer, or device that sends and receives the sound wave signals, is inserted into the vagina. This modified ultrasonographic method permits a more detailed examination of the fetus in the first trimester, and may be useful in detecting congenital abnormalities (birth defects). Early diagnosis of congenital defects reduces the anxiety of waiting for testing at a later period, and avoids the expense and increased risk associated with an abortion in the second trimester of pregnancy. The usefulness of transvaginal ultrasonography in detecting congenital abnormalities in the first trimester was assessed, and the limitations of this diagnostic technique are discussed. The results showed that 33 embryos with structural defects were diagnosed by transvaginal ultrasonography over a period of two years, in a group of 622 women. Thus the rate of these structural defects was 0.5 percent; this low rate may be due to the large number of mothers with a low risk of having pregnancies with congenital defects. Twenty-two of 33 women whose fetuses had congenital abnormalities were considered high-risk patients. Experience with transvaginal ultrasonography and a thorough understanding of the development and growth of the embryo is recommended before use of this method in diagnosing fetal abnormalities in the first trimester of pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Birth defects

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Ultrasonographic criteria for the prenatal diagnosis of placental chorionicity in twin gestations

Article Abstract:

Twin pregnancies can have separate (dichorionic) or shared (monochorionic) fetal membranes. Twins sharing fetal membranes often have a connection between the two fetal blood circulations which can cause complications, such as growth discrepancies and fetal swelling. Close management of these twin pregnancies is required. Separate fetal membranes or different sexed fetuses indicate dichorionic twins. However, when twins are the same sex or one placenta is present other methods of distinguishing between separate or shared fetal membranes must be used. Ultrasonography, the use of high frequency sound to visualize internal structures, was employed to determine criteria which can be used to distinguish between monochorionic and dichorionic fetal membranes. The thickness of the fetal membranes was measured in 32 uncomplicated twin pregnancies. Thicknesses greater than two millimeters indicated dichorionic fetal membranes (95 percent accuracy) and thicknesses which were less indicated monochorionic fetal membranes (82 percent accuracy). Determining the type of fetal membrane is fundamental when deciding management strategies of twin pregnancies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Measurement, Fetal membranes, Twins, Prenatal diagnosis, Chorion

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Transcervical endoscopic verification of congenital anomalies in the second trimester of pregnancy

Article Abstract:

Ultrasonography (US) is a diagnostic imaging technique that uses high-frequency sound waves. It is increasingly being used to diagnose abnormalities in the fetus that may result in choosing to terminate the pregnancy. Diagnosis must be accurate before the parents are counseled regarding the present or future pregnancies. Termination methods usually make confirmation of the diagnosis impossible. This study examined using transcervical endoscopy, a diagnostic technique in which an optical instrument is inserted in the cervix to examine the fetus, to confirm the diagnosis of abnormalities apparent on ultrasound. Endoscopy was performed in 14 patients who were undergoing termination of their pregnancies based upon abnormal ultrasound findings. Results showed that endoscopic visualization of the fetus was complete and agreed with (US) in 10 cases, partially complete and helpful in three cases, and incomplete in one case. Additional information was obtained in two cases, of which the diagnosis changed for one. These results indicate that transcervical endoscopy may be useful in further evaluating the fetus prior to terminating a pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Endoscopy

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