Donald School Journal of Ultrasound in Obstetrics and Gynecology

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2019 | April-June | Volume 13 | Issue 2

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Kenta Yamamoto, Mohamed Ahmed Mostafa AboEllail, Ayumi Mori, Emiko Nitta, Kosuke Koyano, Takashi Kusaka

HDlive Studio and HDlive Silhouette Mode for Antenatal Diagnosis of Apert Syndrome

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:4] [Pages No:55 - 58]

Keywords: 3D ultrasound, Antenatal diagnosis, Apert syndrome, Fetus, HDlive Studio, HDlive silhouette mode

   DOI: 10.5005/jp-journals-10009-1585  |  Open Access |  How to cite  | 


We present our first experience of using HDlive Studio and HDlive silhouette mode to diagnose Apert syndrome. A 31-year-old pregnant Japanese woman was referred to our hospital due to suspected skull bone abnormalities at 20 weeks and 1 day of gestation. Two-dimensional (2D) sonography showed clover leaf-like skull. HDlive Studio clearly depicted brachycephaly. An X-ray mode demonstrated broad metopic and sagittal sutures, and large anterior and posterior fontanels. HDlive silhouette mode clearly showed closures of bilateral coronal sutures. HDlive Studio also depicted fused fingers and toes. Diagnosis of Apert syndrome was highly suggested. She was delivered vaginally of a viable female fetus at 41 weeks and 4 days of gestation. Her birth weight was 3,836 g with an Apgar score of 7 (1 minutes) and 9 (5 minutes), and the umbilical artery pH was 7.208. Craniosynostosis and syndactyly of fingers and toes were noted. Postnatal examination confirmed the diagnosis of Apert syndrome. HDlive Studio can be a useful adjunctive diagnostic tool to confirm fetal congenital anomalies due to realistic, comprehensive images.


Original Article

Nobuhiro Mori, Mohamed Ahmed Mostafa AboEllail, Uiko Hanaoka, Kosuke Koyano, Ikuko Kato, Takashi Kusaka

Mini KANET: Simple Fetal Antenatal Neurodevelopmental Test

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:5] [Pages No:59 - 63]

Keywords: 4D ultrasound, Antenatal fetal neurodevelopmental test, Developmental disability, Mini KANET, Modified KANET

   DOI: 10.5005/jp-journals-10009-1586  |  Open Access |  How to cite  | 


Objective: The objective of this study is to develop a simple antenatal fetal neurodevelopmental test [Mini Kurjak's antenatal neurodevelopmental test (Mini KANET)] for the prediction of postnatal developmental disabilities. Methods: Three hundred and fifty-three healthy fetuses between 28 and 38 weeks of gestation were examined using a four-dimensional ultrasound. Fetal behavior was assessed with the Mini KANET, which consists of three parameters (isolated eye blinking, facial alteration or mouth opening, and isolated leg movement). A score range of 0–1 was characterized as abnormal, and 2–6 was normal. Diagnostic indices for the prediction of postnatal developmental disabilities were compared between the modified and Mini KANET assessments. Results: There were 334 normal (94.6%) and 19 abnormal (5.4%) cases among the 353 fetuses studied with the Mini KANET. Four cases of postnatal developmental disabilities were noted among the 334 normal fetuses (1.19%), whereas four cases of developmental disabilities were found among the 19 abnormal fetuses (21.05%) (p < 0.0001). There was a significant difference in sensitivity between the modified (37.5%) and Mini KANET (50%) assessments (p = 0.001), whereas no significant differences were noted for other diagnostic indices between the two assessments. Conclusion: The Mini KANET may become a simple antenatal fetal neurodevelopmental test for the prediction of postnatal developmental disabilities in healthy fetuses. However, the data and their interpretation in the present study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size are needed to assess the validity of the Mini KANET for the prediction of postnatal developmental disabilities, comparing with the results of modified KANET.



Džihan Abazoviæ, Dušica Ljubiæ, Svetlana Vujoviæ, Danilo Vojvodiæ, Tatjana Božanoviæ, Aleksandar Ljubiæ

Ovarian Rejuvenation

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:5] [Pages No:64 - 68]

Keywords: In vitro activation, Ovarian rejuvenation, PRP, Segova, Stem cells, Tissue engineering

   DOI: 10.5005/jp-journals-10009-1587  |  Open Access |  How to cite  | 


Bckground: Premature ovarian insufficiency (POI) occurs in 1% of cases in women aged 35–40 years and a large number of women of this age are faced with the problem of reduced reproductive ability or losing reproductive ability and a number of other symptoms affecting overall health and quality of life. It has been proven that many genetic and external factors lead to the Hippo signal pathway disruption and follicle growth disruption, resulting in amenorrhea and menopause. Methods: Our study provides concise summary of published data about experimental evidences for the restoration of reproductive ovarian function in women with compromised reproductive health. The database used was Pubmed where full text articles and English-written reviews published between 2004 and 2018 were preferred. The MeSH (Medical Subject Headings) terms used were ‘ovarien rejuvenation’, ‘ovarien follicle activation’, ‘female germline stem cells’, ‘stem cell therapy’ and ‘ovarien insufficiency’, either alone or in combination. The references of the articles were also considered when searching for the most relevant articles. Results: Exposure of ovarian tissues to autologous concentrated growth factors and autologous stem cells results in the Hippo signal path disruption and stimulation of revived follicle growth and improvement of ovarian reproductive function. In vitro ovarian activation represents autologous genetic treatment of the gonadal tissue to restore reproductive and endocrine ovarian function. Among the sleepy follicles, ~ 0.1% of the follicles were selected for activation. Since patients with POIs (primary ovarian insufficiencies) have <1,000 residual follicles, growth factors and maternal cells can activate sleepy follicles. SEGOVA acts on the intracellular signaling system. The use of the SEGOVA method (ovarian in vitro activation by autologous growth factors and autologous stem cells) leads to regeneration and improvement of the reproductive function of the ovaries. Conclusion: In vitro ovarian activation represents autologous genetic treatment of gonadal tissue to restore reproductive and endocrine ovarian function. Oogenesis depends on the proper genetic control. Ovarian function is achieved by the formation of ovarian cells, which is associated with a specific hormone activity. The primitive status of primordial follicles is characterized by communication with the surrounding granulocyte cells and numerous mechanical and chemical factors that control the progression of their cell cycle. Autologous growth factors and autologous stem cell therapy activate genetic pathways, initiate, and promote the development and differentiation of ovarian cells, resulting in improved endocrine status and ovarian function.



Nobuhiro Mori, Mohamed Ahmed Mostafa AboEllail, Emiko Nitta

SMI with Doppler Luminance in Obstetrics

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:9] [Pages No:69 - 77]

Keywords: 3D, Color Doppler, Fetus, Obstetrics, Placenta, Superb microvascular imaging, SMI with Doppler luminance, Ultrasound

   DOI: 10.5005/jp-journals-10009-1588  |  Open Access |  How to cite  | 


Superb microvascular imaging (SMI) with Doppler luminance (Aplio i800, Canon Medical Systems, Tokyo, Japan) is a new color Doppler, which shows three-dimensional SMI information on a two-dimensional gray-scale image by shading based on the amplitude of the color Doppler signal. Moreover, we can obtain more precise vasculature of fetal organs and the placenta using an 18 MHz probe. In this picture-based article, cutting-edge SMI with Doppler luminance features of fetal peripheral vessels and normal and abnormal placentas are presented. Also, to aid investigations of fetal and placental circulations, the present and future applicability of SMI with Doppler luminance is considered.



Priya Pillai, Rana Abualsaud, Zainab Awni, Arash Rafii, Badreldeen Ahmed

OHVIRA Syndrome

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:2] [Pages No:78 - 79]

Keywords: Ipsilateral renal agenesis, Obstructed hemivagina, Right hematocolpos, Uterine didelphys

   DOI: 10.5005/jp-journals-10009-1589  |  Open Access |  How to cite  | 



Syeda Khadija, Sabir Butt, Sadaf Ayesha, Muhammad Yousaf, Annum Majeed

A Rare Case of Complete Thoracic Ectopia Cordis with Clubfeet and Hands

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:3] [Pages No:80 - 82]

Keywords: Ascites, Clubfeet and hands, Ectopia cordis, Thoracoabdominal, Ultrasonography

   DOI: 10.5005/jp-journals-10009-1590  |  Open Access |  How to cite  | 


Ectopia cordis is a rare congenital condition. It is defined as the abnormal position of the heart outside the thoracic cavity, associated with defects in the parietal pericardium, diaphragm, sternum, and, in most cases, cardiac malformations. Ectopia cordis was first proposed by Abott in 1998, although cases of patients with similar defects have been reported in the past. Ectopia cordis is produced by segmental defects in the mesodermal development in the third week of intrauterine life, and/or amniotic band syndrome that causes simultaneous cerebral and thoracoabdominal malformations. The existence of ectopia cordis with severe congenital heart disease may be confirmed in the prenatal period by vaginal echocardiography at 10–12 weeks of gestation or by abdominal echocardiography at 20–22 weeks. For such defects surgical correction is the only hope of survival, although the overall success rate is very poor. In recent years, surgery has been attempted in one or two phases with variable results that depend mainly on the type of associated heart disease. A 37 years old woman with gestational age of 29.5 weeks was referred for third trimester ultrasound to detect fetal anomaly. The fetal heart was seen outside lower the chest wall which was later confirmed by elective cesarean section. The heart was not covered with a membrane (pericardium). The rest of the anterior abdominal wall was intact. The abdomen was distended due to ascites.



Sally DE Mohmmed, Nadia Elrayah, Helmi Noor, Badreldeen Ahmed

Pentalogy of Cantrell

[Year:2019] [Month:April-June] [Volume:13] [Number:2] [Pages:2] [Pages No:83 - 84]

Keywords: Cantrell, Pentalogy of Cantrell, Pentalogy

   DOI: 10.5005/jp-journals-10009-1591  |  Open Access |  How to cite  | 


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