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The article examines the prevalence of fetal isolated short femur in a group of women screened for Down syndrome by the integrated test. It also compares the outcome of fetuses with isolated short femur in the mid-trimester with that of fetuses with normal femur length. Results reveal that isolated short femur in the mid-trimester fetus is related to fetal growth restriction and small-for-gestational age.

Objective To evaluate the potential clinical use of maternal serum free ß-human chorionic gonadotropin (ß-hCG) and uterine artery Doppler investigation to screen for placenta-related adverse outcome in pregnancies at positive risk for Down's syndrome at 15–18 weeks. Design A cohort of 329 consecutive pregnant women with a singleton viable pregnancy and a positive risk for Down's syndrome was retrospectively investigated. This group was obtained from an unselected population of 3952 women attending the same hospital over a 2-year period. Using the results of this first analysis, we selected a group of 26 women with unexplained high levels of free ß-hCG and followed them prospectively with monthly ultrasound and uterine artery Doppler examinations. Results In the retrospective cohort, risk ratios stratified for maternal serum ß-hCG multiple of the median (MoM) values indicated that the highest incidence of adverse pregnancy outcome was in those women with values of ≥5.0. In the prospective study, pregnancy outcome was complicated by uteroplacental disorders in eight cases. Analysis of the Doppler investigation indicated that, in women with a very high level of hCG, an abnormally high uterine artery pulsatility index (PI) had lower sensitivity and negative predictive value than early diastolic notch, whereas the specificity and positive predictive value were higher for a high uterine artery PI. Conclusions These findings suggest an association between a high level of maternal serum ß-hCG at 15–18 weeks, the presence of an early diastolic notch in the uterine artery flow velocity waveform and adverse pregnancy outcome due to abnormal development of the uteroplacental circulation. Young women with an unexplained high ß-hCG level would benefit, apart from detailed sonography of the fetus and/or karyotyping, from uterine Doppler investigation and counselling about the follow-up and management of placenta-related ... [ABSTRACT FROM AUTHOR]

AbstractThe prenatal sonographic features of a fetus with right-sided congenital diaphragmatic hernia diagnosed at 33 weeks are presented. Color Doppler demonstrated an abnormal course of the right renal artery, arising from the aorta and feeding the intrathoracic right kidney. This case report stresses the role of color Doppler in defining which organs have herniated in fetuses with diaphragmatic hernia. [ABSTRACT FROM AUTHOR]