Search

This is a report of an intracerebellar hemorrhage in a severely growth-restricted fetus with pathological Doppler findings of the fetal and uteroplacental circulations. The diagnosis was made sonographically at 22 weeks of gestation and the natural course of the hemorrhage was followed. Interestingly, the final sonographic appearance of the posterior fossa was quite similar to that of the classic form of Dandy-Walker malformation: absence of the vermis and an enlarged fourth ventricle. However, careful sonographic examination showed that the enlargement of the fourth ventricle was actually caused by a porencephalic cystic lesion of the left cerebellar lobe. Pathological examination revealed complete absence of the vermis and cerebellar hypoplasia.

25.4 and 29.4 weeks (median: 27.6) in the group with DV-RF. All blood pressure measurements but one was within or below the 5th percentile standard reference range. Mean systolic and diastolic blood pressure in the group with normal DV was 44 mm/Hg and 24 mm/Hg, respectively; whereas it was 41 mm/Hg and 21 mm/Hg, respectively, in the group with DV-RF. Neither systolic nor diastolic blood pressures were statistically significant between the two groups. However, we estimated that 59 fetuses in each group would be needed to determine whether a difference exists between the two groups. Conclusion: Although this pilot study does not show that IUGR neonates have systemic hypertension, the data suggest that IUGR fetuses with DV-RF might have a higher systemic blood pressure than those with normal DV. A large study with enough power should be conducted to confirm these initial findings.

Objective To discuss the prenatal diagnosis, obstetrical management, and perinatal outcome of duodenal atresia, and investigate the incidence of associated malformations and chromosomal anomalies. Materials and methods The data about 27 fetuses with duodenal atresia which were diagnosed on prenatal sonographic evaluation, and confirmed postnatally, among 20401 high risk pregnancies who were referred to Prenatal Diagnosis Unit of Obstetrics and Gynecology Department of Istanbul Medical Faculty between 1988 and 1999, are analyzed. Presence of polihydramnios, gestational week at diagnosis, associated malformations and chromosomal abnormalities, and perinatal outcomes were evaluated. Fisher's exact test is used for statistical analysis. Results Duodenal atresia was diagnosed in 43 fetuses, but postnatal outcomes of 38 fetuses could be obtained. Ten of the fetuses had additional abnormalities in 27 cases whom diagnosis was confirmed. Nine chromosomal abnormalities (33.3%) including seven trisomy 21 (29.6%), one deletion, one translocation anomaly detected. The perinatal mortality of duodenal atresia is found 44.4% with 12 pre and postnatal deaths. Fifteen infants discharged in a healthy condition after operations. Conclusion Duodenal atresia, especially in the presence of associated abnormalities has a high perinatal mortality. Establishment of diagnosis in prenatal period, even in the late stages of gestation, may contribute the obstetrical and neonatal management.