Two Fetuses with Prominent Eustachian Valve in One Family: Fetal Echocardiographic Features
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:3] [Pages No:209 - 211]
Keywords: 3D reconstruction, Fetal echocardiography, HDlive, Prominent eustachian valve, Sibling occurrence
DOI: 10.5005/jp-journals-10009-2030 | Open Access | How to cite |
Abstract
Background: There have been some reports on prenatal diagnosis of a prominent eustachian valve, which can mimic a cardiac tumor in the right atrium. However, there has been no report on the sibling occurrence of persistent eustachian valves. Here, we present two fetuses (brothers) with a prominent eustachian valve in one family, diagnosed prenatally with fetal echocardiography and HDlive. Case description: In the first fetus (older brother), fetal echocardiography with second-trimester fetal screening showed a mobile, elongated, solid tumor (2.9 mm) at the base of the right atrium at 19 weeks and 3 days of gestation. The neonatal echocardiographic diagnosis was persistent eustachian valve. In the second fetus (younger brother), fetal echocardiography with third-trimester fetal screening showed a mobile, round, solid tumor (3.4 × 2.5 mm) at the base of the right atrium at 29 weeks and 4 days of gestation. HDlive clearly demonstrated a round tumor vibrating left and right, which was synchronized with systole and diastole, near the inferior vena cava. The neonatal echocardiographic diagnosis was persistent eustachian valve. Conclusion: This is the first report on two fetuses (brothers) with a prominent eustachian valve in one family. HDlive facilitates visualization of three-dimensional fetal intracardiac structures, such as a prominent eustachian valve.
Evaluation of Kurjak Antenatal Neurodevelopmental Test in Hypothyroidic Pregnant Women
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:7] [Pages No:212 - 218]
Keywords: Euthyroid, Fetal behavior, Hypothyroidism, Kurjak's Antenatal Neurodevelopmental Test
DOI: 10.5005/jp-journals-10009-2032 | Open Access | How to cite |
Abstract
Objective: Assessing fetal behavior in utero is challenging and of great value for perinatal screening, but the evolution of ultrasonography has led to a better comprehension of fetal pathology. Antenatal screening for early detection of fetal neurological well-being has provided valuable information. The aim of this study is to determine a possible correlation between hypothyroidism in pregnancy and altered fetal behavior. Materials and methods: Kurjak antenatal neurodevelopmental test (KANET) was applied from 28 weeks to 38 weeks in 85 gestations (group A) with hypothyroidism and 87 euthyroid pregnant women (group B). Results: No statistically significant differences were observed considering maternal age (29.2 ± 4.9 years for group A vs 29.7 ± 3.3 years for group B) and gestational age (GA) (33 ± 1.6 weeks for hypothyroidic compared to 33 ± 2.1 weeks for euthyroidic group). The control group reported higher KANET scores than group A. Conclusion: It appears that fetal behavior differences are observed in women with hypothyroidism.
Abscesses Arising from Endometrioma
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:5] [Pages No:219 - 223]
Keywords: Abscess, Endometrioma, Endometriosis, Ovary
DOI: 10.5005/jp-journals-10009-2038 | Open Access | How to cite |
Abstract
Endometriosis is a chronic disease affecting 10–15% of women in their reproductive years. It is characterized by the presence of functional glands and stroma in sites outside the endometrial cavity. Lesions can be found on ovaries, fallopian tubes, peritoneum, intestines, bladder, diaphragm, and may also occur in other parts of the body. Two-dimensional (2D) and three-dimensional (3D) ultrasonography and color Doppler are essential techniques in detecting endometrioma. Ovarian abscess is a rare gynecologic entity in contrast to the more commonly encountered tubo-ovarian abscess. This report describes a case of an ovarian abscess arising within an endometrioma. The woman presented with pain, bloating, and a slightly elevated body temperature of 37.8°C. She had a history of endometrioma detected many years ago. The ultrasound image showed a large unilocular cyst, with a thickened cystic wall and accumulation of the dense parts of the content. The surgical specimen revealed typical endometrial glandular cells, endometrial stroma, and a pronounced inflammatory process around the cells.
Ovarian Cystadenomas of Borderline Malignancy
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:7] [Pages No:224 - 230]
Keywords: Borderline ovarian tumors, Epithelial neoplasms, Ovary tumors, Recurrent borderline tumors
DOI: 10.5005/jp-journals-10009-2037 | Open Access | How to cite |
Abstract
Epithelial neoplasms of the ovary account for 60% of all ovarian tumors. They classify as benign, borderline, or malignant tumors. The type borderline malignancy is a type of tumor that, despite having malignant potential, is not invasive and has a clinically indolent course. Borderline tumors usually affect women aged between 20 and 40 years. They are diagnosed at an early stage. In this report, a 68-year-old woman with pelvic pain and abdominal discomfort several months after total hysterectomy with bilateral adnexectomy as a treatment for mucinous borderline malignancy ovarian tumor is presented. Ultrasound imaging showed a multilocular cystic tumor with a heterogeneous pattern, smooth borders, and thick vascularized septa with solid fraction in the internal wall. Relaparotomy was performed with pathohistology of recurrent mucinous atypical borderline tumor.
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:3] [Pages No:231 - 233]
Keywords: Diagnosis, Prognosis, Single umbilical artery
DOI: 10.5005/jp-journals-10009-2035 | Open Access | How to cite |
Abstract
A single umbilical artery (SUA), resulting in a two-vessel cord instead of a three-vessel cord, is the most common umbilical cord abnormality in humans with a prevalence of 1 in 100–200 pregnancies. In approximately 65% of cases, SUA is an isolated finding. Of those cases with SUA, the left umbilical artery is absent in approximately 70%. The incidence of SUA in twins is higher than in singletons, with no relation to chorionicity. Approximately 33% of fetuses with SUA have additional structural anomalies, and 10% are affected by aneuploidy. The most common chromosomal abnormalities are trisomy 18, trisomy 13, and triploidy, which together account for 82.9% of cases. An SUA is associated with over twofold increased risk of intrauterine growth restriction (IUGR), threefold increased risk of renal anomalies, and >20-fold increased risk of cardiac anomalies. Abnormalities affecting cardiovascular, skeletal, gastrointestinal, genitourinary, and central nervous systems are found in 20% of cases. It is usually identified sonographically when an artery is visible coursing adjacent to the fetal bladder along only one side. Although SUA may be visible in the first trimester, it is usually identified during the routine second-trimester fetal anatomic survey. The prognosis of the fetus with an SUA is determined by the presence of other malformations; in isolated cases, the prognosis is normal.
Fetal and Maternal Physiology and Ultrasound Diagnosis
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:27] [Pages No:234 - 260]
Keywords: Development and functions of the placenta, Fetal and maternal physiology, Ultrasound
DOI: 10.5005/jp-journals-10009-2034 | Open Access | How to cite |
Abstract
Maternal, fetal, and placental factors are involved in the growth, development, and metabolism of the fetus. This paper presents the development of the placenta and its functions, fetal growth and metabolism, the structural and functional development of the fetal organ systems, and fetal stress and its prenatal and postnatal consequences.
Ectopic Pregnancy: Diagnosing and Treating the Challenge
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:21] [Pages No:261 - 281]
Keywords: Biochemical markers, Color and pulsed Doppler ultrasound, Ectopic pregnancy, Three-dimensional ultrasound, Transvaginal ultrasound
DOI: 10.5005/jp-journals-10009-2040 | Open Access | How to cite |
Abstract
Ectopic pregnancy remains a significant clinical challenge, with early and accurate diagnosis being critical for effective management and reducing morbidity. This review article discusses the combined use of advanced ultrasound techniques alongside biochemical markers to enhance the detection and treatment of ectopic pregnancies. Transabdominal and transvaginal ultrasounds provide initial assessment, with transvaginal imaging offering superior resolution for early detection. Doppler ultrasound, particularly color and pulsed Doppler, is instrumental in evaluating blood flow, helping to distinguish between viable and nonviable pregnancies. Three-dimensional ultrasound further enhances diagnostic precision by offering detailed spatial imaging, which aids in localization and assessment of ectopic sites. Additionally, biochemical markers, particularly serum β human chorionic gonadotropin (beta hCG) levels, complement imaging by providing crucial insights into pregnancy viability and progression. By integrating these modalities, this approach aims to improve diagnostic accuracy, facilitate timely intervention, and optimize patient outcomes in cases of ectopic pregnancy.
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:16] [Pages No:282 - 297]
Keywords: Chemotherapy, Color/power Doppler flow mapping, Real-time B-mode, Three-dimensional image, Three-dimensional power Doppler
DOI: 10.5005/jp-journals-10009-2042 | Open Access | How to cite |
Abstract
Although trophoblastic diseases were frequent in East Asia in the past, choriocarcinoma is rare at present after the introduction of effective chemotherapy and postmolar management in Japan. Molar pregnancy has also decreased, possibly due to ultrasound diagnosis and termination in early pregnancy. The outcome of the disease has greatly improved by ultrasound diagnosis, including real-time B-mode, color/power Doppler flow images, and pulsed Doppler tumor blood flow studies.
Kurjak Antenatal Neurodevelopment Test: A Comprehensive Review
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:5] [Pages No:298 - 302]
Keywords: Fetal brain imaging, Kurjak antenatal neurodevelopmental test, Neurodevelopmental disorders, Prenatal diagnosis, Ultrasound
DOI: 10.5005/jp-journals-10009-2049 | Open Access | How to cite |
Abstract
The Kurjak antenatal neurodevelopment test (KANET) is a pioneering prenatal diagnostic tool designed to evaluate fetal neurodevelopment using high-resolution ultrasonography and detailed neuroimaging analysis. This review provides an in-depth analysis of KANET's methodology, clinical applications, and its significant role in enhancing prenatal care. By integrating advanced imaging techniques with precise neurodevelopmental assessments, KANET enables early detection and intervention for neurodevelopmental disorders, potentially improving long-term outcomes. The review also discusses KANET's validation across diverse populations, its comparative effectiveness with traditional diagnostic methods, and the future potential for incorporating emerging technologies to further refine prenatal diagnostics.
Agenesis of Ductus Venosus Detected at 13 Weeks of Gestation: HDlive Flow Features
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:4] [Pages No:303 - 306]
Keywords: Case report, 3D reconstruction, Agenesis of ductus venosus, Dandy–Walker variant, First trimester, HDlive Flow, Radiant Flow
DOI: 10.5005/jp-journals-10009-2031 | Open Access | How to cite |
Abstract
Objective: To present three-dimensional reconstruction of agenesis of ductus venosus (ADV) using HDlive Flow in the first trimester of pregnancy. Case description: A 35-year-old pregnant Japanese woman was referred to our ultrasound clinic at 13 weeks and 6 days of gestation because of fetal generalized skin edema. Color Doppler and HDlive Flow revealed ADV. Moreover, HDlive Flow clearly showed the spatial relationships among the descending aorta, umbilical vein, intrahepatic drainage to portal vein, and inferior vena cava. Chromosome analysis using amniocentesis at 16 weeks and 5 days revealed 46, XY. Second-trimester fetal screening at 18 weeks and 5 days showed partial agenesis of the cerebellar vermis (Dandy–Walker variant) and ADV. Magnetic resonance imaging (MRI) confirmed partial agenesis of the cerebellar vermis at 33 weeks and 6 days of gestation. Conclusion: HDlive Flow should be used as an adjunctive modality to diagnose fetal vascular abnormalities such as ADV even in the first trimester of pregnancy.
Maturity-onset Diabetes of the Young During Pregnancy
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:4] [Pages No:307 - 310]
Keywords: Case report, Glucokinase-related maturity-onset diabetes of the young, Maturity-onset diabetes of the young, Pregnancy
DOI: 10.5005/jp-journals-10009-2033 | Open Access | How to cite |
Abstract
Maturity-onset diabetes of the young (MODY) is a rare form of diabetes that is different from both type 1 and type 2 diabetes and runs strongly in families, with autosomal dominant inheritance. Currently, there are 14 different types of MODY depending on the gene disorder. Glucokinase-related MODY (MODY 2) is a common form of this disorder. Mutations in the gene are associated with gestational diabetes and deviation of the average fetal birth weight. The main features of MODY are: (1) diabetes developing before the age of 25 years, (2) family history, (3) diabetes treated by diet or less often by tablets, and (4) absence of obesity (although overweight or obese people can get MODY) or other problems associated with type 2 diabetes or metabolic syndrome. We present the case of a 35-year-old Caucasian primigravida with a medical and family history of MODY type 2, who attended our unit due to fetal growth restriction (FGR) and increased umbilical artery (UA) Doppler pulsatility index (PI) at 28 weeks of gestation and delivered at 36+6 weeks. Management of such cases requires specific knowledge and a multidisciplinary approach.
Epstein–Barr Virus as a Risk Factor for Fetal Hypoxia and Preterm Birth: A Case Report
[Year:2024] [Month:July-September] [Volume:18] [Number:3] [Pages:7] [Pages No:311 - 317]
Keywords: Adverse pregnancy outcomes, Case report, Epstein–Barr virus (EBV), Perinatal infections, Preterm birth, Stress-induced immune dysregulation
DOI: 10.5005/jp-journals-10009-2036 | Open Access | How to cite |
Abstract
Adverse pregnancy outcomes, including preterm birth, are markedly higher among patients with perinatal infections. Stress-induced immune dysregulation may contribute to these effects. Epstein–Barr virus (EBV) infection rarely affects the course of pregnancy since only a few pregnant women are susceptible to the virus; however, when there is a primary infection with severe symptoms, the management of the pregnancy is very challenging for both the patient and the obstetrician. We report a rare case of a 20-year-old primigravida who gave preterm birth due to EBV infection causing fetal hypoxia.