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Abstract: Objective. – A prospective study of pregnancy outcome in fetuses with increased nuchal translucency above the 95th centile (group NT) or cystic hygroma (group CH) at 10 to 14 weeks of gestation was performed. Patients and methods. – Maternal and fetal data (nuchal translucency, caryotype, pregnancy outcome) and infant follow-up of 223 fetuses with first trimester nuchal translucency thickness (183 NT and 40 CH) were analysed. Results. – The measurement of nuchal translucency thickness shows a significant difference between group CH and NT (7.4±2.9 mm compared 3.7±0.8 mm). Chromosomal abnormalities were present in 55% (22/40) in group CH, with 9 cases/22 (40.9%) of Turner syndrome, compared with 14.2% (26/183) in group NT with trisomy 21 in 15 cases/26 (57.7%) (P <0.05). The rate of unfavourable outcome of pregnancy (spontaneous abortion, elective termination of pregnancy, serious structural anomalies) was 80% (32/40) in group CH compared with 18% (33/183) in group NT (P <0.05). In chromosomally normal pregnancies, the rate of fetus with no visible serious structural anomalies was 44.4% (8/18) in group CH compared with 93% (146/157) in group NT (P <0.05). Discussion and conclusion. – Our data show ultrasonographic evaluation of the fetal nuchal translucency thickness at the first trimester is actually indispensable. Neonatal outcome and malformation rate in fetuses with increased nuchal translucency or cystic hygroma are different, even with normal karyotype. [Copyright &y& Elsevier]

Objectives: To assess prenatal changes in the volume of congenital pulmonary malformations (CPM) and examine whether these changes differ in lesions that appear cystic on ultrasound compared with hyperechoic lesions, and to study the relationship between CPM volume and risk of fetal compression.Methods: We conducted a nationally representative, multicenter, prospective cohort study, which included 579 ultrasound examinations in 176 pregnant women with a diagnosis of fetal CPM, between March 2015 and November 2016. Several ultrasound examinations were performed between diagnosis and delivery, including measurement of CPM volume. We modeled changes in CPM volume ratio (CVR) as a function of gestational age, overall and for cystic/mixed vs hyperechoic malformations, and examined the association between CVR and signs of compression during pregnancy.Results: When modeling CVR changes over time, there was a statistically significant decrease in CVR with increasing gestational age (P < 0.001), but the pattern of change differed according to CPM phenotype at first ultrasound examination: cystic/mixed CPM were characterized by a monotonic decrease in CVR with increasing gestational age (P = 0.002), whereas hyperechoic CPM showed an initial increase in CVR up to 27 weeks of gestation, followed by a decrease thereafter (P < 0.001). Peak CVR values were predicted as early as 21-22 weeks for cystic/mixed CPMs compared with 25-26 weeks for hyperechoic malformations. Regardless of CPM phenotype, fetuses that showed no sign of compression at any point had substantially lower CVR at first CVR measurement, and the CVR remained relatively constant thereafter. Among the subpopulation of fetuses with no sign of compression at first CVR measurement, the odds of a subsequent compression was 7-fold higher (adjusted odds ratio, 7.0; 95% CI, 1.6-29.9) if initial CVR was > 0.4 vs CVR ≤ 0.4 cm2 .Conclusions: Predicted changes in CVR during pregnancy differ between cystic and hyperechoic malformations. This may be the result of different pathophysiological mechanisms or differences in the timing of occurrence of these different types of CPM. CVR measured at the initial diagnostic ultrasound examination was strongly associated with the odds of subsequent compression. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Résumé Objectif Le laparoschisis complexe est difficile à dépister en anténatal et pourtant, il est associé à une augmentation de la morbimortalité importante. L’objectif principal de cette étude était de définir les facteurs de risque échographiques et obstétricaux associés à une évolution post-natale défavorable. Méthodes Il s’agit d’une étude rétrospective et observationnelle portant sur tous les cas de laparoschisis pris en charge au centre hospitalier universitaire de Reims, entre 2005 et 2015. Le critère de jugement principal était le décès néonatal lié au laparoschisis. Les critères secondaires échographiques et obstétricaux étudiés étaient les dilatations digestives intra- ou extra-abdominales, la quantité de liquide, la croissance fœtale, la vitalité fœtale, le rythme cardiaque fœtal, la voie d’accouchement, le poids et le terme de naissance. Résultats Nous avons observé 28 naissances vivantes avec 16 enfants avec une évolution favorable, 8 enfants avec nécessité de plusieurs interventions et 4 décès. Il n’y avait pas de critères échographiques significativement liés à une évolution post-natale défavorable. Parmi les critères obstétricaux, la voie d’accouchement n’influait pas sur l’évolution post-natale, seul le poids de naissance inférieur à 2000 g était associé à une augmentation de syndrome de grêle court ( p = 0,049). Conclusion Seul le poids de naissance inférieur à 2000 g semble associé à une évolution post-natale défavorable. Objective Prenatal diagnosis of complex laparoschisis is difficult and yet it is associated with a significantly increased morbidity and mortality. The aim of the study was to define ultrasonographic factor and obstetrical criteria to predicting adverse neonatal outcome. Methods Retrospective cohort study over 10 years, of 35 gastroschisis cases in CHU of Reims (France). The primary outcome was the neonatal death due to gastroschisis. The sonographic markers was bowel dilatation intra- or extra-abdominale, amniotic fluid, intra-uterin growth. The obstetrical criteria was fetal vitality, fetal heart rate, type of delivery, the weight and the term of birth. Results There were 28 live births, 16 children with favorable outcome, 8 children with adverse perinatal outcome and 4 deaths. There were any sonographic criteria to predicting adverse neonatal outcome. Only the birth weight less than 2000 g was associated with an increase gastrointestinal complications ( P = 0.049). The type of the delivery was not associated with an adverse prenatal outcome. Conclusion The birth weight less than 2000 g seems to be associate with an increase gastrointestinal complications. It is important to fight against prematurity in case of gastroschisis. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 30-year-old woman, who was referred for a second-trimester ultrasound examination. The patient had undergone medical termination of pregnancy at 26 weeks of amenorrhea for pulmonary agenesis, but there was no further relevant family history and no consanguinity with her husband.