Diagnostic Tactics in the Absence of Ultrasound Images of the Gallbladder

Objective: determine the optimal checklist of diagnostic procedures, whose application will make it possible to effectively identify and differentiate malformations of the biliary system of the fetus accompanied by the absence of ultrasound imaging of the gallbladder. Material . The fetuses in single-fetal pregnancy in the period of gestation of 16-37 weeks were examined. Results. The study has determined the optimal checklist of the diagnostic procedures, including dynamic sonography, biochemical amniotic fluid test, magnetic resonance imaging, which should be carried out in the absence of ultrasound imaging of the gallbladder during the screening ultrasound examination of pregnant women aimed at the identification of the congenital malformations of the fetus. The cases and conditions of the biochemical amniotic fluid testing have been identified. The standards of the percentile values of the total alkaline phosphatase and gamma-glutamyl transpeptidase concentrations in amniotic fluid have been developed. Conclusion. If the gall bladder of the fetus cannot be visualized by ultrasound, isolated agenesis of the gall bladder, atresia of the biliary tract, cystic fibrosis, aneuploidy, multiple congenital malformations should be suspected. In view of the extremely unfavorable prognosis in case of biliary atresia, the verification ultrasound examination should be repeated dynamically several times over the next week, and if the gallbladder is not detected, then for the differential diagnosis it is necessary to use additional methods such as MRI and biochemical amniotic fluid test in order to determine changes in their concentration of digestive enzymes in comparison with the normative values determined by the authors.

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AN ULTRASOUND SURVEY ON THE PLACENTA AND AMNIOTIC CHARACTERISTICS IN THE SINGLE POSTTERM PREGNANCY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.3 ◽

2011 ◽

pp. 20-24

Author(s):

Thi My Dung Ha ◽

Ngoc Thanh Cao ◽

Thi Song Huong Tran

Keyword(s):

Amniotic Fluid ◽

Ultrasound Images ◽

Ultrasound Scanning ◽

Amniotic Fluid Index ◽

Postterm Pregnancy ◽

Fluid Properties ◽

Labor Transfer ◽

The Relationship ◽

Obstetric Department ◽

Singleton Pregnancies

Objective: To characterize ultrasound images of placenta and amniotic fluid in cases of singleton pregnancies beyond term predictions, and also explore the relationship between placenta, amniotic fluid and labor transfer status, postpartum child status. Image properties of prenatal placenta and amniotic fluid are immediately examined with ultrasound in 267 cases of postterm pregnancy beyond prediction at Obstetric Department, Hue Central Hospital. Results: In postterm pregnancy, placenta thickness decreases gradually according to gestational age. Oligohydramnios is 30.3%. There is a correlation between amniotic fluid index and birth method with r = 0.41. Sensitivity is 89.15%. Specificity is 48.55%. There is also a correlation between amniotic fluid echogenicity and method of birth: r = 0.478. Sensitivity is 97.67%. Specificity is 42.75%. Amniotic fluid index and baby Clifford's syndrome are also relevant, with r=0.466. Sensitivity is 83.78%. Specificity is 78.26%. Conclusions: Ultrasound scanning of amniotic fluid properties should be noted in the case of postterm pregnancy.

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Ultrasound Imaging of the Spine for Central Neuraxial Blockade: a Technical Description and Evidence Update

Current Anesthesiology Reports ◽

10.1007/s40140-021-00456-3 ◽

2021 ◽

Author(s):

Hari Kalagara ◽

Harsha Nair ◽

Sree Kolli ◽

Gopal Thota ◽

Vishal Uppal

Keyword(s):

Ultrasound Imaging ◽

Spine Surgery ◽

Postoperative Analgesia ◽

Spinal Deformity ◽

Ultrasound Examination ◽

Technical Difficulty ◽

Vertebral Level ◽

Reliable Technique ◽

Neuraxial Blockade ◽

Preprocedural Imaging

Abstract Purpose of Review This article describes the anatomy of the spine, relevant ultrasonographic views, and the techniques used to perform the neuraxial blocks using ultrasound imaging. Finally, we review the available evidence for the use of ultrasound imaging to perform neuraxial blocks. Recent Findings Central neuraxial blockade using traditional landmark palpation is a reliable technique to provide surgical anesthesia and postoperative analgesia. However, factors like obesity, spinal deformity, and previous spine surgery can make the procedure challenging. The use of ultrasound imaging has been shown to assist in these scenarios. Summary Preprocedural imaging minimizes the technical difficulty of spinal and epidural placement with fewer needle passes and skin punctures. It helps to accurately identify the midline, vertebral level, interlaminar space, and can predict the depth to the epidural and intrathecal spaces. By providing information about the best angle and direction of approach, in addition to the depth, ultrasound imaging allows planning an ideal trajectory for a successful block. These benefits are most noticeable when expert operators carry out the ultrasound examination and for patients with predicted difficult spinal anatomy. Recent evidence suggests that pre-procedural neuraxial ultrasound imaging may reduce complications such as vascular puncture, headache, and backache. Neuraxial ultrasound imaging should be in the skill set of every anesthesiologist who routinely performs lumbar or thoracic neuraxial blockade. We recommend using preprocedural neuraxial imaging routinely to acquire and maintain the imaging skills to enable success for challenging neuraxial procedures.

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Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis

Diagnosis ◽

10.1515/dx-2020-0109 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Elham Kebriyaei ◽

Ali Davoodi ◽

Seyed Alinaghi Kazemi ◽

Zahra Bazargani

Keyword(s):

Ultrasound Imaging ◽

Maternal Education ◽

Left Kidney ◽

Ultrasound Images ◽

Fetal Ultrasound ◽

Renal Anomalies ◽

Cross Sectional ◽

Fetal Hydronephrosis ◽

Kidney Involvement

Abstract Objectives Renal anomalies are the most common fetal abnormalities that occur during prenatal development, and are typically detected by observing hydronephrosis on fetal ultrasound imaging. Follow-up with post-natal ultrasound is important to detect clinically-important obstruction, because many of the pre-natal abnormalities resolve spontaneously. This study aimed to evaluate the postnatal hydronephrosis follow-up rate, and reasons for non follow-up in affected neonates. Methods In this cross-sectional study all neonates born during a period of one year at Ayatollah Mousavi Hospital with hydronephrosis on fetal ultrasound imaging were recruited. All mothers were also given face-to-face information about fetal hydronephrosis and its postnatal outcomes, and follow-up with at least a postnatal ultrasound was recommended from the fourth day of their neonates’ birth until the end of the fourth week. The neonates were subsequently observed for one month to determine the postnatal ultrasound follow-up rate and to reflect on diagnostic test results, reasons for failure to follow-up, as well as causes of hydronephrosis. Results In this study, 71 cases (1.2%) out of 5,952 neonates had fetal hydronephrosis on prenatal ultrasound images. The postnatal ultrasound imaging showed kidney involvement in 18 neonates (25%), particularly in the left kidney (61.1%). Seven neonates had no follow-up at one month (10%). No significant relationship was found between lack of follow-up and the neonates’ place of residence (p=0.42), maternal education (p=0.90), number of siblings (p=0.33), or gender (p=0.64). Conclusions Postnatal ultrasound follow-up rate in these neonates with a history of fetal hydronephrosis was incomplete even though parents had been provided with education and advice at their birth time. Accordingly, it is recommended to perform postnatal ultrasound once neonates are discharged from hospitals.

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Oligohydramnion in the First Half of Pregnancy in the Fetuses with Congenital Abnormalities: Ultrasound Diagnostics and Obstetric Outcomes

Annals of the Russian academy of medical sciences ◽

10.15690/vramn1443 ◽

2021 ◽

Vol 76 (4) ◽

pp. 341-350

Author(s):

Sergey M. Voevodin ◽

Tatiana V. Shemanaeva ◽

Alyona V. Serova

Keyword(s):

Amniotic Fluid ◽

Congenital Malformations ◽

Fetal Death ◽

Congenital Abnormalities ◽

Neonatal Period ◽

Perinatal Outcomes ◽

Main Group ◽

Obstetric Outcomes ◽

Fetal Abnormalities ◽

4D Ultrasound

Background.Oligohydramnion in the first half of pregnancy, combined with congenital abnormalities in the fetus has objective difficulties in diagnosis. The morphology features and type of defects associated with oligohydramnion, which manifests in the first half of pregnancy, are not sufficiently studied at the present stage. Aims to evaluate the clinical significance of diagnosing oligohydramnion in the first half of pregnancy in women with congenital fetal malformations. Materials and methods.The analysis of the course of pregnancy and perinatal outcomes in 77 women with low water content in combination with congenital malformations of the fetus and 72 patients with a normal amount of amniotic fluid and no congenital malformations of the fetus was performed. The patients of the main group were divided into two subgroups depending on the severity of oligohydramnion: the 1st subgroup (n = 54) patients with severe oligohydramnion and the 2nd subgroup (n = 23) patients with moderate oligohydramnion. The amount of amniotic fluid was determined by 3D/4D ultrasound (1321 weeks of gestation) and the structure of fetal abnormalities associated with oligohydramnion was analyzed. We evaluated perinatal outcomes in women with congenital malformations of the fetus in combination with oligohydramnion and the effect of its severity on the outcome of pregnancy. Results.In the main group (n = 77), fetal abnormalities were detected in patients: urinary system 39 (50.6%), respiratory system 4 (5.2%), heart 1 (1.3%), chromosomal and genetic abnormalities 14 (18.2%), central nervous system 3 (3.9%), osseous system 3 (3.9%), multiple 13 (16.9%). In the main group (n = 77), pregnancy was terminated for medical indications in 47 (61%) cases, in 6 (7.8%) spontaneous miscarriage occurred, in 5 (6.5%) antenatal fetal death. 19 (24.7%) children were born alive, and surgical treatment in the neonatal period was required in 8 (10.4%) cases. In the 1st subgroup (n = 54) in 53 (98.1%) cases, there was a loss of the fetus, in 1 (1.9%) the newborn died on the 9th day. In the 2nd subgroup (n = 23), fetal death occurred in 5 (21.7%) cases, 18 (78.3%) children were born alive, and 8 (44.4%) newborns were operated on in the neonatal period. In the control group, all pregnancies ended with the birth of healthy children. A decrease in ultrasound imaging of internal organs in the fetus was observed when a pregnant woman was obese (BMI more than 35). Conclusions.Oligohydramnion in the first half of pregnancy in combination with fetal malformation should be considered an extremely unfavorable clinical sign for the prognosis of pregnancy and the health of the fetus and newborn. 3D/4D ultrasound scanning allows you to reliably determine oligohydramnion in the first half of pregnancy, and the degree of its severity to assume the nature of complications.

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Advances in ultrasound imaging for congenital malformations during early gestation

Birth Defects Research Part A Clinical and Molecular Teratology ◽

10.1002/bdra.23353 ◽

2015 ◽

Vol 103 (4) ◽

pp. 260-268 ◽

Cited By ~ 6

Author(s):

William F. Rayburn ◽

Jennifer A. Jolley ◽

Lynn L. Simpson

Keyword(s):

Ultrasound Imaging ◽

Congenital Malformations ◽

Early Gestation

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Prenatal diagnosis of severe congenital malformations associated with elevated amniotic fluid alpha-feto protein

Clinical Genetics ◽

10.1111/j.1399-0004.1979.tb01745.x ◽

2008 ◽

Vol 15 (4) ◽

pp. 351-355 ◽

Cited By ~ 6

Author(s):

J. CHEMKE ◽

R. NlSANl ◽

R. KASSIF ◽

M. LANCET ◽

R. BEISER ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Amniotic Fluid ◽

Congenital Malformations ◽

Alpha Feto Protein

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High-definition ultrasound imaging defines the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2020-102304 ◽

2021 ◽

pp. rapm-2020-102304

Author(s):

Pornpatra Areeruk ◽

Manoj Kumar Karmakar ◽

Miguel A Reina ◽

Louis Y H Mok ◽

Ranjith Kumar Sivakumar ◽

...

Keyword(s):

Brachial Plexus ◽

Ultrasound Imaging ◽

Brachial Plexus Block ◽

Ultrasound Images ◽

High Definition ◽

Link Type ◽

Before And After ◽

Registration Number ◽

Local Anesthetic Injection ◽

Plexus Block

Background and objectivesThe paraneural sheath is a multilayered network of collagen fibers that surround the brachial plexus. Currently, there are no sonographic data on the paraneural sheath of the brachial plexus, which this study aimed to evaluate.MethodsUltrasound imaging datasets of 100 patients who received a costoclavicular brachial plexus block, using high-definition ultrasound imaging, were retrospectively reviewed. Video files, representing sonograms before and after the local anesthetic injection, from the costoclavicular space and lateral infraclavicular fossa were collated and reviewed by three experienced anesthesiologists. Frequency (yes/no) of ultrasound visualization of the paraneural sheath, septum, and the anterior and posterior compartments was assessed. Representative sonograms from the costoclavicular space and lateral infraclavicular fossa were visually correlated with archived cadaver microanatomic sections from the same location.ResultsDatasets of the 98 patients who achieved surgical anesthesia were evaluated. The paraneural sheath, septum, and the anterior and posterior compartments were visualized in 17.3%, 7.1%, 5.1% and 5.1%, respectively, at the costoclavicular space before the brachial plexus block; this contrasts (p<0.001) with their visibility post-block (94.9%, 75.5%, 75.5% and 75.5%, respectively). At the lateral infraclavicular fossa, the corresponding visibility of these structures post-block were 67.7%, 81.5%, 81.5% and 81.5%, respectively. Ultrasound images of the paraneural sheath and septum correlated well with that in the cadaver microanatomic sections.ConclusionWe have demonstrated the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa using high-definition ultrasound imaging.Trial registration numberClinicalTrials.gov Registry (NCT04370184), (https://www.clinicaltrials.gov/).

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Prenatal Sonographic Image of Sirenomelia with Anencephaly and Craniorachischisis Totalis

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/7058253 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Takako Sugiura ◽

Yuka Sato ◽

Naoyuki Nakanami ◽

Kiyomi Tsukimori

Keyword(s):

Ultrasound Examination ◽

Color Doppler ◽

Three Dimensional ◽

Final Diagnosis ◽

Color Doppler Ultrasound ◽

Lower Limbs ◽

Ultrasound Images ◽

Two Dimensional ◽

Prenatal Counselling ◽

Medical Termination

Sirenomelia is a rare congenital malformation characterized by varying degrees of fusion of the lower extremities. It is commonly associated with severe urogenital and gastrointestinal malformations; however, the association of sirenomelia with anencephaly and rachischisis totalis is extremely rare. To our knowledge, the prenatal sonographic images of this association have not been previously published. Here, we present prenatal sonographic images of this association, detected during the 17th week of gestation through combined two-dimensional, four-dimensional, and color Doppler ultrasound. Two-dimensional ultrasound images showed anencephaly, spina bifida, and possible fusion of the lower limbs. Three-dimensional HDlive rendering images confirmed the final diagnosis of sirenomelia with anencephaly and rachischisis totalis. The patient opted to undergo medical termination of pregnancy and delivered a fetus with fused lower limbs, anencephaly, and rachischisis totalis confirming the in utero imaging findings. Awareness of these rare associations will help avoid misdiagnoses and facilitate prenatal counselling. This case highlights the importance of a thorough ultrasound examination.

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