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Objective: This study was designed to correlate ultrasound-observed fetal eye movements with fetal heart rate reactivity to determine its potential role in fetuses with persistent non-reactivity. Methods: A total of 104 non-stress tests (NSTs) were evaluated in 62 patients referred for fetal surveillance for standard antepartum indications. Ultrasound-observed eye movements, assessed during portions of these NSTs, were categorized as negative (0), intermittent (1-5/min), or rapid (≥ 6/min). Results: Of the NSTs, 97 were reactive and seven were non-reactive. All studied fetuses were apparently healthy, as the seven patients with persistently non-reactive NSTs had biophysical profile scores of 8/10. During the NSTs, 120 reactive portions and 81 non-reactive portions were evaluated for ultrasound-observed eye movements. During reactive portions, eye movements were negative 19% of the time, intermittent 24% of the time and rapid 56% of the time. During non-reactive portions, eye movements were negative 84% of the time, intermittent 7.8% of the time and rapid 7.8% of the time. All fetuses demonstrating eye movements during non-reactive periods became reactive shortly thereafter, and all of the seven persistently non-reactive fetuses displayed negative ultrasound-observed eye movements throughout the entire observation period. Conclusions: Healthy fetuses display a strong relationship between non-reactive heart rate tracings and absent or diminished eye movements, consistent with quiet sleep. Conversely, reactive periods are associated with a high incidence of rapid eye movement. Further study is needed in fetuses documented to be hypoxic.

Several authors have reported the value of the sonographic assessment of both the fetal frontal lobe and the cerebellum. Both frontal lobe shortening and cerebellar hypoplasia have been associated with fetal aneuploidy. We anecdotally observed that the distance between the calvarium and the posterior cavum septum pellucidum (frontal lobe) closely approximated the transcerebellar diameter. This study was undertaken to investigate this relationship.

Intrauterine growth retardation (IUGR) complicates about 5% of all pregnancies and is responsible for substantial perinatal mortality and morbidity. With ultrasound, it is possible to assess fetal brain growth indirectly by measurement of the biparietal diameter, head circumference and transcerebellar diameter. As liver size is affected most profoundly by IUGR, measurement of the abdominal circumference of the fetus provides the earliest evidence of fetal growth restriction. Placental size, assessed with ultrasound, can also indicate the severity of the condition. Once a fetus is diagnosed as having IUGR, its well‐being can be monitored with standard heart‐rate testing and ultrasound assessment of fetal behaviour. Doppler analysis of the wave form of the fetal arterial and venous circulation hold the greatest promise for managing pregnancies complicated by IUGR. □ Intrauterine growth retardation, fetal growth, ultrasound measurements, brain growth, liver growth, placental size

Amniotic fluid cortisol concentration was compared with lecithin/ sphingomyelin ratio, gestational age, and eventual birthweight in a large series of normal and high-risk human pregnancies in an effort to determine whether cortisol could be used as a reliable indicator of fetal maturity. It appears that when used alone amniotic fluid cortisol is of limited clinical value as an antepartum predictor of fetal respiratory status because of unacceptable percentages of false positive and false negative predictions. Whether amniotic fluid cortisol can be used as an adjunct in the evaluation of high-risk pregnancies with “transitional” L/S ratios remains to be explored.

Amniotic fluid cortisol (AFC) levels were measured in 76 normal and 67 high-risk human pregnancies. When compared to normal gestations, diabetic pregnancies were found to be associated with lower AFC levels, while toxemic, early Rh-sensitized, and other stressed pregnancies had higher mean cortisol values. Serially followed normal and high-risk pregnancies showed a progressive rise in AFC with increasing gestational age. Significant correlation between AFC concentrations and lecithin/sphingomyelin (L/S) ratios was noted in normal, diabetic, and toxemic gestations. These results are concordant with the hypothesis that cortisol may be involved in fetal lung development.

Isolated ‘mild renal collecting system dilatation’ (mild pyelectasis) is a common prenatal sonographic finding. An association between mild pyelectasis and fetal aneuploidy has been established, but in the absence of a concomitant anomaly, mild pyelectasis is usually regarded as benign and of no clinical consequence, and, follow‐up is often not obtained after the initial ascertainment. To test this, we investigated the relationship between mild pyelectasis and (1) progression to hydronephrosis; (2) postnatal vesicoureteral reflux (VUR.); and (3) postnatal surgery.

The object of this study was to establish new normative data for the fetal rib cage perimeter to thoracic circumference ratio, and to evaluate the potential application of this measurement in the diagnosis of short rib and other skeletal dysplasias. Rib cage perimeter (RCP) and thoracic circumference (TC) were measured in a prospective, cross‐sectional sample of 88 patients with normal pregnancies between 14 and 39 weeks of gestation. The RCP and TC were both measured in cross‐section, at a level of the four‐chamber view of the fetal heart. RCE and TC measurements were also obtained from eight cases known to have skeletal dysplasias.