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Abnormal fetal tongue size is a phenotypic feature of various syndromes including Beckwith‐Wiedemann, Pierre‐Robin, oromandibular limb hypoplasia, chromosomal aberrations, etc. Current data regarding normal fetal tongue size are limited. Hence, micro/macroglossia are subjectively determined. The aim of the study was to construct a contemporary fetal tongue nomogram and to assess its clinical contribution. A prospective cross‐sectional study was performed in well dated, low risk, singleton pregnancies. Fetal tongues were measured by 5 trained sonographers. Highest quality images were selected. Intra‐ and interobserver variability was assessed. Tongue length, width, area, and circumference 1st to 99th centiles were calculated for each gestational week. Based on the normal tongue size charts, we created a Tongue Centile Calculator. Over 18 months, 664 tongue measurements were performed. A cubic polynomial regression model best described the correlation between tongue size and gestational age. The correlation coefficient (r2) was 0.934, 0.932, 0.925, and 0.953 for tongue length, width, area, and circumference, respectively (P< .001). Intra‐ and interobserver variability had high interclass correlation coefficients (>0.9). Using the new charts, we were able to identify 2 cases of macroglossia, subsequently diagnosed with Beckwith‐Wiedemann, and 4 cases of microglossia, 3 associated with Pierre‐Robin sequence, and 1 associated with persistent buccopharyngeal membrane. We present novel fetal tongue size charts from 13 to 40 weeks of gestation. Clinical application of these nomograms may be beneficial in the prenatal diagnosis of syndromes or malformations associated with abnormal fetal tongue size.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2006.06.066 Byline: Yoav Yinon (a), Maya Spira (a), Ofira Solomon (b), Boaz Weisz (a), Benjamin Chayen (a), Eyal Schiff (a), Shlomo Lipitz (a) Abstract: The purpose of this study was to evaluate noninvasive management of alloimmune thrombocytopenia that included only the blind administration of immunoglobulin. Author Affiliation: (a) Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center (b) Department of Hematology, Amalia Biron Research Institute of Thrombosis and Hemostasis, the Chaim Sheba Medical Center, Tel-Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Article History: Received 9 March 2006; Revised 31 May 2006; Accepted 17 June 2006 Article Note: (footnote) Presented at the 26th Annual Meeting of the Society for Maternal Fetal Medicine, January 30-February 4, 2006, Miami, Florida.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2005.03.043 Byline: Michal Berkenstadt (a), Boaz Weisz (a), Howard Cuckle (b), Michal Di-Castro (a), Esther Guetta (a), Gad Barkai (a) Abstract: To determine whether colchicine prescribed for familial Mediterranean fever is teratogenic. Author Affiliation: (a) Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel (b) Department of Reproductive Epidemiology, University of Leeds, Leeds, United Kingdom Article History: Received 14 November 2004; Revised 3 March 2005; Accepted 19 March 2005

Women with diabetes during pregnancy will reach maximal blood sugar values one hour after breakfast but two hours after dinner. This could occur because dinner contains more protein and fat than breakfast. Diabetics may want to wait until two hours after dinner to measure their blood sugar levels.

ObjectiveOesophageal atresia (OA) is a major anomaly of varying severity. The complexity of surgical correction highly depends on the gap length of missing oesophagus and the presence of a distal fistula. The aim of this study was to identify antenatal sonographic findings associated with presence of a distal fistula and type of surgical repairMethodsPrenatal medical records of neonates postnatally diagnosed with OA were reviewed. Sonographic signs of OA (small/absent stomach, polyhydramnios, oesophageal pouch) and the trimester at sign detection were recorded and compared between (1) OA with and without a distal fistula and (2) early one-step versus delayed two-step anastomosis. Multivariate analysis was performed.ResultsOverall, 80 cases of OA were included. Absence of a distal fistula was significantly associated with higher rates of small/absent stomach (100% vs 28.6%, P<0.0001), oesophageal pouch (100% vs 24.3%, P<0.0001) and severe polyhydramnios (66.7% vs 22.9%, P=0.006), compared with OA with a distal fistula.Cases requiring a delayed two-step repair had higher rates of small/absent stomach (84.2% vs 16.7%, P>0.0001), severe polyhydramnios (47.4% vs 16.7%, P=0.008) and oesophageal pouch (73.7% vs 18.5%, P<0.0001), compared with those corrected in an early one-step anastomosis.Multivariate logistic regression found small/absent stomach and pouch to be significantly and independently associated with a delayed two-step anastomosis.ConclusionOA without a distal fistula is associated with higher rates of prenatal sonographic signs. Both small/absent stomach and a pouch are independently associated with a delayed two-step anastomosis. These findings may help improve antenatal parental counselling regarding the anticipated surgical repair.

In this cohort study, we show that fetuses infected during the second trimester of pregnancy by cytomegalovirus are at risk for minor sequelae, mainly partial unilateral hearing loss, which may present late in childhood. Prenatal imaging does not predict childhood outcome.

To evaluate the outcome of infants born to mothers with varicella zoster virus (VZV) infection in pregnancy who had second trimester amniocentesis for detection of placental transfer.

To assess parameters associated with perinatal and neonatal morbidity and mortality in monochorionic (MC) diamniotic twin pregnancies after 25 weeks of gestation.

Safely targeting the fetal gastrointestinal tract during early gestation is essential to develop effective prenatal gene therapy for gastrointestinal diseases. In this study, we aimed to characterize the development of the fetal sheep stomach sonographically and to determine the optimum gestational age, as well as the shortterm morbidity and mortality of early-gestation ultrasound-guided intragastric injection.

Since the introduction of antenatal serum screening for Down’s syndrome (DS) more than two decades ago, several screening approaches have been utilized in routine clinical practice. The current DS screening strategies involve mid-trimester serum biochemistry tests, first trimester tests combining sonographic markers and serum biochemistry and integration of first and second trimester markers. In this review, we evaluate the performance of DS screening strategies according to the Serum, Urine and Ultrasound Screening Study (SURUSS), the First and Second Trimester Evaluation of Risks (FASTER) Trial and the Serum Biochemistry and Fetal Nuchal Translucency Screening (BUN) Study. We also evaluate the performance of first trimester screening in studies and meta-analyses by other groups. Specific issues related to assisted reproduction technology (ART) pregnancies are also addressed in this review.

Cancer is the second most common cause of death in the reproductive years and complicates up to one in 1000 pregnancies. When cancer is diagnosed during pregnancy, the management strategy must take into account both the mother and developing fetus. In this article, the four most common malignancies diagnosed in pregnant patients – cervical and breast cancer, malignant melanoma and lymphoma – will be reviewed, with an emphasis on the impact of the diagnosis and management on the pregnant patient and the developing fetus.

Objective.This study aimed to evaluate topoisomerase II compared to Ki-67 expression as a marker for tumor behavior and for prognosis of patients with ovarian cancer.

Spontaneous rupture of the uterus during the 2ndand 3rdtrimester resulting from invasive placentation is a rare complication of pregnancy. We report a case of a 39-year-old G6P4, with four previous cesarean sections, who presented at mid-gestation with brown vaginal discharge. Invasive placenta previa was detected upon conducting abdominal ultrasound. The fetal head was seen trapped within the uterine scar, while the fetal body was visualized within the maternal abdominal cavity with intact membranes. In cases with invasive placentation, early attention to uterine rupture may reduce maternal morbidity.

A lipophilic farnesyl moiety attached to the carboxyl terminal cysteine of ras proteins structurally supports their membrane anchorage, required for ras-dependent growth-factor signaling and for transforming activity of ras oncoproteins. It has been shown that inhibition of ras farnesylation can block tumor growth in nude mice but that some ras-dependent tumors escape such blockage as a result of prenylation of ras. S-trans-transfarnesylthiosalicylic acid (FTS) is a potent ras-dislodging antagonist that does not affect ras prenylation but rather acts on the mature, membrane-bound ras and facilitates its degradation. Here we demonstrate that FTS induces reappearance of stress fibers in H-ras-transformed rat-1 cells (EJ cells) in vitro, inhibits their anchorage-independent growth in vitro, and blocks EJ-tumor growth in nude mice. The anchorage-independent growth of cells expressing ErbB2 (B104), but not that of v-raf-transformed cells, is also inhibited by FTS, suggesting specificity towards activated ras. FTS treatment (5 mg/kg i.p. daily) caused inhibition (75–80%) of tumor growth in nude mice implanted with EJ, but not in mice implanted with v-raf-transformed cells, with no evidence of systemic toxicity. Moreover, FTS treatment increased the survival rate of EJ-tumor-bearing mice from 48 to 68 days. Here we demonstrate anti-tumor potency in a synthetic, non-toxic, ras-dislodging antagonist acting independently of farnesyltransferases. Int. J. Cancer 80:911–918, 1999. © 1999 Wiley-Liss, Inc.

Immunocompetence in the developing fetus is temporally and spatially regulated.